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Journal of Interventional Cardiac Electrophysiology
Published in: Journal of Interventional Cardiac Electrophysiology 1/2009

01-10-2009

Femoral vascular complications following catheter ablation of atrial fibrillation

Authors: Liza A. Prudente, J. Randall Moorman, Douglas Lake, Yuping Xiao, Heather Greebaum, J. Michael Mangrum, John P. DiMarco, John D. Ferguson

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 1/2009

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Abstract

Background

Femoral vascular complications remain a significant complication of catheter ablation of atrial fibrillation as a result of peri-procedural anticoagulation protocols.

Objective

We investigated the effect of three different anti-coagulation regimens on the incidence of femoral vascular complications following AF ablation over a 4 year period.

Methods

We performed 603 catheter ablations in 539 patients from January 2004 to January 2008. All patients were started on coumadin immediately after procedure and received enoxaparin at 1 mg/kg 4 h post procedure and again 12 h later. Three protocols for enoxaparin, administered 12 hourly, were used post-procedure: Protocol A—1 mg/kg × ten doses; Protocol B—1 mg/kg × six doses, and Protocol C—0.5 mg/kg × six doses. We documented occurrence of femoral vascular complications prior to discharge and at the 1 month post-op visit using a prospective database. A femoral vascular complication was defined as hematoma requiring prolonged hospitalization, blood transfusion or surgical intervention.

Results

There were 21 femoral vascular complications during the study period. The rate of complication fell from 5.7% (protocol A) to 1.6% (protocol C) (p < 0.03). We attribute the decrease in complication rate to the shorter anticoagulation protocol, as the reduction remained significant regardless of variation in catheter sizes. There were no new cerebral vascular events with the lower enoxaparin protocols.

Conclusion

A shorter course of post procedure anticoagulation protocol can reduce femoral complications without contributing to increased risk of thromboembolic events.
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Metadata
Title
Femoral vascular complications following catheter ablation of atrial fibrillation
Authors
Liza A. Prudente
J. Randall Moorman
Douglas Lake
Yuping Xiao
Heather Greebaum
J. Michael Mangrum
John P. DiMarco
John D. Ferguson
Publication date
01-10-2009
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 1/2009
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-009-9402-y

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