Academic Journal
Implementation of a Standardized Nurse-Guided Heparinization Protocol Improves Anticoagulation During Left Atrial Ablation Procedures.
| Τίτλος: | Implementation of a Standardized Nurse-Guided Heparinization Protocol Improves Anticoagulation During Left Atrial Ablation Procedures. |
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| Συγγραφείς: | Sciacca V; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Retzlaff J; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Braun M; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Fink T; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Darma A; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Bocchini Y; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Harutyunyan K; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Lucas P; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Trajkovksa N; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Guckel D; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Khalaph M; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Moersdorf M; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Didenko M; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Sohns C; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany., Sommer P; Department of Electrophysiology, Heart- and Diabetescenter NRW, Ruhr-University Bochum, Bochum, Germany. |
| Πηγή: | Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2026 Jul; Vol. 37 (7), pp. 1504-1513. Date of Electronic Publication: 2026 May 18. |
| Τύπος έκδοσης: | Journal Article; Research Support, Non-U.S. Gov't |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Malden, MA : Blackwell Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990- |
| Ιατρικοί όροι (MeSH): | Heparin*/administration & dosage , Heparin*/adverse effects , Anticoagulants*/administration & dosage , Anticoagulants*/adverse effects , Catheter Ablation*/adverse effects , Catheter Ablation*/nursing , Atrial Fibrillation*/surgery , Atrial Fibrillation*/diagnosis , Atrial Fibrillation*/physiopathology , Atrial Fibrillation*/nursing , Blood Coagulation*/drug effects , Tachycardia, Supraventricular*/surgery , Tachycardia, Supraventricular*/diagnosis , Tachycardia, Supraventricular*/physiopathology , Tachycardia, Supraventricular*/nursing , Practice Patterns, Nurses'*/standards , Drug Monitoring*/nursing , Nurse's Role*, Humans ; Female ; Middle Aged ; Treatment Outcome ; Male ; Time Factors ; Aged ; Risk Factors ; Drug Administration Schedule |
| Περίληψη: | Background and Aims: Effective intraprocedural anticoagulation is essential during catheter ablation of atrial fibrillation (AF) and left atrial tachycardia (AT) procedures. This study evaluated a novel, standardized, nurse-led heparin protocol regarding anticoagulation performance and safety. Methods: Consecutive patients undergoing AF or AT ablation between May 2022 and 2023 were treated using a standardized heparinization protocol managed by electrophysiology nursing staff (study group) and compared with consecutive patients undergoing ablation between May 2021 and April 2022, in whom heparin was administered at the operator's discretion (control group). Patients in the study cohort received an initial dose of 5000 IU heparin after venous access and a supplemental bolus (1000 IU/10 kg above 50 kg bodyweight) after transseptal puncture. ACT was then assessed every 20 min using a point-of-care coagulation device in both groups. Repeat heparin administration was autonomously performed by nurses in the study group following a standardized protocol. The primary endpoint was the proportion of patients in whom at least one intraprocedural ACT measurement exceeded 300 s at any time during the procedure. Results: Each group included 655 patients with comparable baseline characteristics. The study group more frequently achieved the therapeutic target (ACT > 300 s, 84.6% vs. 59.7%, p < 0.0001), reached therapeutic ACT faster, and showed fewer exclusively subtherapeutic ACT values. Excessive anticoagulation was less common (ACT > 400 s: 2.0% in the study group vs. 5.0% in the control group, p = 0.0027). Complication rates were low and similar in both groups. Conclusions: A standardized, nurse-led heparinization protocol improved the speed, consistency, and precision of intraprocedural anticoagulation during left atrial ablation without increasing procedural complications. (© 2026 The Author(s). Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: ACT; anticoagulation; atrial fibrillation; catheter ablation; heparin; nurse‐led protocol; workflow |
| Substance Nomenclature: | 9005-49-6 (Heparin) 0 (Anticoagulants) |
| Entry Date(s): | Date Created: 20260518 Date Completed: 20260716 Latest Revision: 20260917 |
| Update Code: | 20260917 |
| PubMed Central ID: | PMC13372408 |
| DOI: | 10.1111/jce.70378 |
| PMID: | 42150016 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1540-8167 |
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| DOI: | 10.1111/jce.70378 |