Efficacy and Safety of a Nurse-Driven Heparin Protocol During Atrial Fibrillation Ablation
Document Type
Conference Proceeding
Publication Date
4-2025
Publication Title
Heart Rhythm
Abstract
Background: Atrial fibrillation (AF) is a common arrhythmia with significant morbidity and mortality. Anticoagulation during AF ablation is essential to minimize thromboembolic complications. Protocols for achieving therapeutic activated clotting times (ACT) are varied, and a nurse-driven heparinization protocol may offer streamlined, efficient anticoagulation.
Objective: To assess the efficacy and safety of a nurse-driven, ACT-guided heparin protocol in patients undergoing AF ablation.
Methods: In this retrospective study, patients undergoing AF ablation received weight-adjusted, nurse-driven heparin management targeting an ACT ≥ 350 seconds. Efficacy endpoints included time to target ACT and percentage of ACT values within the therapeutic range. Safety was assessed by the incidence of 30-day stroke, bleeding events, and mortality. Comparisons across different BMI categories were conducted to assess consistency in outcomes and identify potential variations in efficacy and safety.
Results: Of 476 patients who underwent AF ablation between 7/1/2022 and 4/30/2023, 336 (71%) achieved a therapeutic ACT following an initial heparin loading dose, with a mean time of 18 minutes to reach the target. Thirty-day stroke incidence was low (0.4%), and major bleeding occurred in 0.2% of patients. Minor bleeding events and rehospitalization were observed in 3.3% and 4.8% of patients respectively.
Conclusion: This nurse-driven, ACT-guided heparin protocol achieved therapeutic ACT efficiently and safely, with minimal adverse events. These findings support a streamlined, standardized approach to anticoagulation during AF ablation that is minimally reliant on physician oversight.
Volume
22
Issue
4 Suppl
First Page
S343
Last Page
S344
Recommended Citation
Hollowell M, Kerndt C, El Shami M, Bury A, Pasion T, Alameh S, et al [Tietema J, Ahmed M, Marsy D, Phad M, Albano AJ, Brunner M, Dahu M, Dandamudi S, Gauri A, Jawad W, Tankut S, Chalfoun N]. Efficacy and safety of a nurse-driven heparin protocol during atrial fibrillation ablation. Heart Rhythm. 2025;22(4 Suppl):S343-S4. doi: 10.1016/j.hrthm.2025.03.939.
DOI
10.1016/j.hrthm.2025.03.939
ISSN
1556-3871
Comments
Heart Rhythm Society Annual Meeting, April 24-27, 2025, San Diego, CA