The management of cardiac tamponade complications during catheter ablation of atrial ifbrillation ;using different periprocedure anticoagulation strategies
10.3969/j.issn.1004-8812.2014.04.002
- VernacularTitle:不同抗凝策略对心房颤动导管消融心脏压塞并发症处理的影响
- Author:
Caihua SANG
;
Jianzeng DONG
;
Deyong LONG
;
Ronghui YU
;
Ribo TANG
;
Rong BAI
;
Nian LIU
;
Ke CHEN
;
Chenxi JIANG
;
Man NING
;
Songnan LI
;
Yingwei CHEN
;
Changsheng MA
- Publication Type:Journal Article
- Keywords:
Atrial ifbrillation;
Ablation;
Cardiac tamponade;
Anticoagulation
- From:
Chinese Journal of Interventional Cardiology
2014;(4):210-214
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the management and outcome of the cardiac tamponade patients during the ablation procedure using two different anticoagulation strategies. Methods All the patients developed tamponade during the ablation procedure were enrolled from January 2007 to December 2013 in our center. In group 1, warfarin was discontinued 3 to 5 days before the procedure and low molecular weight heparin (LMWH) was administered subcutaneously until ablation procedure day. In group 2, warfarin was not discontinued and the international normalized ratio INR was to maintained between 2 and 3. Results There were 27 patients (0.6%) developed cardiac tamponade out of a total 4487 patients received ablation in our center. The baseline clinical characteristics including age, left atrium, the heparin dose and ACT during the procedure had no signiifcant difference between the groups, except that the INR was higher in the group 2 (0.9±0.1 vs. 2.3±0.5, P<0.001). There was no signiifcant difference in the amount of pericardiac drainage between the two groups (365±222 ml vs. 506±300 ml, P=0.137). Two patients in group 1 patient (11.1%) and 1 in group 2 (11.1%) needed emergency surgical repair (P>0.999). The median hospital day was similar in the 2 groups [(9.6±3.3) d vs. (12.1±4.5) d, P=0.167]. There were no other serious complications and no hospital death. Conclusions Non-discontinuation of warfarin during peri-procedural catheter ablation of AF is not signiifcantly different to bridging with LMWH in the management and outcome of acute cardiac tamponade.
