Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range

Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range

This study evaluated whether a novel standardized heparin dosing protocol used during atrial fibrillation catheter ablation resulted in a higher percentage of therapeutic activated clotting time (ACT) values compared to historic nonstandardized procedures. A retrospective cohort study SETTING: This...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of cardiothoracic and vascular anesthesia 2024-01, Vol.38 (1), p.67-72
Hauptverfasser: Ural, Kelly G, Moridzadeh, Sina S, Busch, Eric H, Masri, Omar El, Burton, Jeffrey H, Morin, Daniel P
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 72
container_issue 1
container_start_page 67
container_title Journal of cardiothoracic and vascular anesthesia
container_volume 38
creator Ural, Kelly G
Moridzadeh, Sina S
Busch, Eric H
Masri, Omar El
Burton, Jeffrey H
Morin, Daniel P
description This study evaluated whether a novel standardized heparin dosing protocol used during atrial fibrillation catheter ablation resulted in a higher percentage of therapeutic activated clotting time (ACT) values compared to historic nonstandardized procedures. A retrospective cohort study SETTING: This study was conducted at Ochsner Medical Center, the largest tertiary-care teaching hospital in New Orleans, LA PARTICIPANTS: Patients undergoing catheter-based atrial fibrillation ablation INTERVENTIONS: The authors implemented a standardized heparin protocol, and enrolled 202 patients between November 2020 and March 2021. The historic controls consisted of 173 patients who underwent atrial fibrillation ablation between April 2020 and September 2020. Heparin administration in the control group was based on physician preference and was nonstandardized. The primary endpoint was the percentage of intraprocedural ACTs in therapeutic range (≥300 to 450 s). Comparisons were performed using chi-squared tests or Fisher exact tests. Patients in the intervention group had a higher mean percentage of ACTs in the therapeutic range compared to the control group (84.9% vs. 75.8%, p
doi_str_mv 10.1053/j.jvca.2023.11.015
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2895702854</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2895702854</sourcerecordid><originalsourceid>FETCH-LOGICAL-c254t-bf51ca346b3d30f686b8ebc81954ec1bad6225fb79dd3579703ef34cdc0d01af3</originalsourceid><addsrcrecordid>eNo9kctOwzAQRS0E4v0DLJCXbBL8iJt0WVW8pAoQtGvLsceQKomL7RTBD_DbOOKxmjuac0ejuQidUZJTIvjlOl9vtcoZYTynNCdU7KBDKjjLqoKx3aQTlZGyJAfoKIQ1IZQKUe6jA14RTgpWHqKvVQDsLFb4Ht7xc1S9Ud40n2Dwqrde6di4XsXU3sJG-abHj95Fp12LrfN4ATZmz41J81ndqhEeAQ1m8BDwXbfxbpvEsukAJ3N8Bbx8Ba82MMRG49l8iZ9U_wInaM-qNsDpbz1Gq-ur5fw2Wzzc3M1ni0wzUcSstoJqxYtJzQ0ndlJN6gpqXdGpKEDTWpkJY8LW5dQYLsppSThYXmijiSFUWX6MLn72psPeBghRdk3Q0LaqBzcEyaqpKAmrRJFQ9oNq70LwYOXGN53yH5ISOb5WruUYgBwDkJTKFEAynf_uH-oOzL_l7-P8G4NmhAo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2895702854</pqid></control><display><type>article</type><title>Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range</title><source>Access via ScienceDirect (Elsevier)</source><creator>Ural, Kelly G ; Moridzadeh, Sina S ; Busch, Eric H ; Masri, Omar El ; Burton, Jeffrey H ; Morin, Daniel P</creator><creatorcontrib>Ural, Kelly G ; Moridzadeh, Sina S ; Busch, Eric H ; Masri, Omar El ; Burton, Jeffrey H ; Morin, Daniel P</creatorcontrib><description>This study evaluated whether a novel standardized heparin dosing protocol used during atrial fibrillation catheter ablation resulted in a higher percentage of therapeutic activated clotting time (ACT) values compared to historic nonstandardized procedures. A retrospective cohort study SETTING: This study was conducted at Ochsner Medical Center, the largest tertiary-care teaching hospital in New Orleans, LA PARTICIPANTS: Patients undergoing catheter-based atrial fibrillation ablation INTERVENTIONS: The authors implemented a standardized heparin protocol, and enrolled 202 patients between November 2020 and March 2021. The historic controls consisted of 173 patients who underwent atrial fibrillation ablation between April 2020 and September 2020. Heparin administration in the control group was based on physician preference and was nonstandardized. The primary endpoint was the percentage of intraprocedural ACTs in therapeutic range (≥300 to &lt;450 s). Secondary endpoints included first measured ACT at ≥300 s and percent of measured ACTs in the supratherapeutic range (&gt;450 s). Comparisons were performed using chi-squared tests or Fisher exact tests. Patients in the intervention group had a higher mean percentage of ACTs in the therapeutic range compared to the control group (84.9% vs. 75.8%, p&lt;0.001). More patients in the intervention group reached therapeutic ACT on the first measurement compared to the control group (70.3% vs. 31.2%, p&lt;0.001). During catheter-based cardiac ablation procedures, a novel standardized unfractionated heparin dosing protocol resulted in a higher percentage of ACTs in the target range, and a higher proportion of initial ACTs in the therapeutic range compared with baseline nonstandardized heparin dosing.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2023.11.015</identifier><identifier>PMID: 38030427</identifier><language>eng</language><publisher>United States</publisher><ispartof>Journal of cardiothoracic and vascular anesthesia, 2024-01, Vol.38 (1), p.67-72</ispartof><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c254t-bf51ca346b3d30f686b8ebc81954ec1bad6225fb79dd3579703ef34cdc0d01af3</cites><orcidid>0000-0002-9637-9507 ; 0000-0002-1575-832X ; 0000-0001-5267-1277</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38030427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ural, Kelly G</creatorcontrib><creatorcontrib>Moridzadeh, Sina S</creatorcontrib><creatorcontrib>Busch, Eric H</creatorcontrib><creatorcontrib>Masri, Omar El</creatorcontrib><creatorcontrib>Burton, Jeffrey H</creatorcontrib><creatorcontrib>Morin, Daniel P</creatorcontrib><title>Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>This study evaluated whether a novel standardized heparin dosing protocol used during atrial fibrillation catheter ablation resulted in a higher percentage of therapeutic activated clotting time (ACT) values compared to historic nonstandardized procedures. A retrospective cohort study SETTING: This study was conducted at Ochsner Medical Center, the largest tertiary-care teaching hospital in New Orleans, LA PARTICIPANTS: Patients undergoing catheter-based atrial fibrillation ablation INTERVENTIONS: The authors implemented a standardized heparin protocol, and enrolled 202 patients between November 2020 and March 2021. The historic controls consisted of 173 patients who underwent atrial fibrillation ablation between April 2020 and September 2020. Heparin administration in the control group was based on physician preference and was nonstandardized. The primary endpoint was the percentage of intraprocedural ACTs in therapeutic range (≥300 to &lt;450 s). Secondary endpoints included first measured ACT at ≥300 s and percent of measured ACTs in the supratherapeutic range (&gt;450 s). Comparisons were performed using chi-squared tests or Fisher exact tests. Patients in the intervention group had a higher mean percentage of ACTs in the therapeutic range compared to the control group (84.9% vs. 75.8%, p&lt;0.001). More patients in the intervention group reached therapeutic ACT on the first measurement compared to the control group (70.3% vs. 31.2%, p&lt;0.001). During catheter-based cardiac ablation procedures, a novel standardized unfractionated heparin dosing protocol resulted in a higher percentage of ACTs in the target range, and a higher proportion of initial ACTs in the therapeutic range compared with baseline nonstandardized heparin dosing.</description><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo9kctOwzAQRS0E4v0DLJCXbBL8iJt0WVW8pAoQtGvLsceQKomL7RTBD_DbOOKxmjuac0ejuQidUZJTIvjlOl9vtcoZYTynNCdU7KBDKjjLqoKx3aQTlZGyJAfoKIQ1IZQKUe6jA14RTgpWHqKvVQDsLFb4Ht7xc1S9Ud40n2Dwqrde6di4XsXU3sJG-abHj95Fp12LrfN4ATZmz41J81ndqhEeAQ1m8BDwXbfxbpvEsukAJ3N8Bbx8Ba82MMRG49l8iZ9U_wInaM-qNsDpbz1Gq-ur5fw2Wzzc3M1ni0wzUcSstoJqxYtJzQ0ndlJN6gpqXdGpKEDTWpkJY8LW5dQYLsppSThYXmijiSFUWX6MLn72psPeBghRdk3Q0LaqBzcEyaqpKAmrRJFQ9oNq70LwYOXGN53yH5ISOb5WruUYgBwDkJTKFEAynf_uH-oOzL_l7-P8G4NmhAo</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Ural, Kelly G</creator><creator>Moridzadeh, Sina S</creator><creator>Busch, Eric H</creator><creator>Masri, Omar El</creator><creator>Burton, Jeffrey H</creator><creator>Morin, Daniel P</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9637-9507</orcidid><orcidid>https://orcid.org/0000-0002-1575-832X</orcidid><orcidid>https://orcid.org/0000-0001-5267-1277</orcidid></search><sort><creationdate>202401</creationdate><title>Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range</title><author>Ural, Kelly G ; Moridzadeh, Sina S ; Busch, Eric H ; Masri, Omar El ; Burton, Jeffrey H ; Morin, Daniel P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c254t-bf51ca346b3d30f686b8ebc81954ec1bad6225fb79dd3579703ef34cdc0d01af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ural, Kelly G</creatorcontrib><creatorcontrib>Moridzadeh, Sina S</creatorcontrib><creatorcontrib>Busch, Eric H</creatorcontrib><creatorcontrib>Masri, Omar El</creatorcontrib><creatorcontrib>Burton, Jeffrey H</creatorcontrib><creatorcontrib>Morin, Daniel P</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ural, Kelly G</au><au>Moridzadeh, Sina S</au><au>Busch, Eric H</au><au>Masri, Omar El</au><au>Burton, Jeffrey H</au><au>Morin, Daniel P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2024-01</date><risdate>2024</risdate><volume>38</volume><issue>1</issue><spage>67</spage><epage>72</epage><pages>67-72</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>This study evaluated whether a novel standardized heparin dosing protocol used during atrial fibrillation catheter ablation resulted in a higher percentage of therapeutic activated clotting time (ACT) values compared to historic nonstandardized procedures. A retrospective cohort study SETTING: This study was conducted at Ochsner Medical Center, the largest tertiary-care teaching hospital in New Orleans, LA PARTICIPANTS: Patients undergoing catheter-based atrial fibrillation ablation INTERVENTIONS: The authors implemented a standardized heparin protocol, and enrolled 202 patients between November 2020 and March 2021. The historic controls consisted of 173 patients who underwent atrial fibrillation ablation between April 2020 and September 2020. Heparin administration in the control group was based on physician preference and was nonstandardized. The primary endpoint was the percentage of intraprocedural ACTs in therapeutic range (≥300 to &lt;450 s). Secondary endpoints included first measured ACT at ≥300 s and percent of measured ACTs in the supratherapeutic range (&gt;450 s). Comparisons were performed using chi-squared tests or Fisher exact tests. Patients in the intervention group had a higher mean percentage of ACTs in the therapeutic range compared to the control group (84.9% vs. 75.8%, p&lt;0.001). More patients in the intervention group reached therapeutic ACT on the first measurement compared to the control group (70.3% vs. 31.2%, p&lt;0.001). During catheter-based cardiac ablation procedures, a novel standardized unfractionated heparin dosing protocol resulted in a higher percentage of ACTs in the target range, and a higher proportion of initial ACTs in the therapeutic range compared with baseline nonstandardized heparin dosing.</abstract><cop>United States</cop><pmid>38030427</pmid><doi>10.1053/j.jvca.2023.11.015</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-9637-9507</orcidid><orcidid>https://orcid.org/0000-0002-1575-832X</orcidid><orcidid>https://orcid.org/0000-0001-5267-1277</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 1053-0770
ispartof Journal of cardiothoracic and vascular anesthesia, 2024-01, Vol.38 (1), p.67-72
issn 1053-0770
1532-8422
language eng
recordid cdi_proquest_miscellaneous_2895702854
source Access via ScienceDirect (Elsevier)
title Use of a New Standardized Unfractionated Heparin Protocol for Left-Sided Ablation Procedures Improves Time in the Therapeutic ACT Range
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T00%3A32%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Use%20of%20a%20New%20Standardized%20Unfractionated%20Heparin%20Protocol%20for%20Left-Sided%20Ablation%20Procedures%20Improves%20Time%20in%20the%20Therapeutic%20ACT%20Range&rft.jtitle=Journal%20of%20cardiothoracic%20and%20vascular%20anesthesia&rft.au=Ural,%20Kelly%20G&rft.date=2024-01&rft.volume=38&rft.issue=1&rft.spage=67&rft.epage=72&rft.pages=67-72&rft.issn=1053-0770&rft.eissn=1532-8422&rft_id=info:doi/10.1053/j.jvca.2023.11.015&rft_dat=%3Cproquest_cross%3E2895702854%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2895702854&rft_id=info:pmid/38030427&rfr_iscdi=true