HRS Guidelines Bundle (free trial)

Catheter and Surgical Ablation of Atrial Fibrillation

Heart Rhythm Society GUIDELINES Apps brought to you free pf charge, courtesy of Guideline Central. Enjoy!

Issue link: https://eguideline.guidelinecentral.com/i/842907

Contents of this Issue

Navigation

Page 11 of 33

12 Treatment During ablation Heparin should be administered prior to or immediately following transeptal puncture during AF catheter ablation procedures and adjusted to achieve and maintain an activated clotting time (ACT) of at least 300 seconds. 1 B-NR Administration of protamine following AF catheter ablation to reverse heparin is reasonable. 2A B-NR Postablation In patients who are not therapeutically anticoagulated prior to catheter ablation of AF and in whom warfarin will be used for anticoagulation postablation, low molecular weight heparin or intravenous heparin should be used as a bridge for initiation of systemic anticoagulation with warfarin following AF ablation. 1 C-EO Systemic anticoagulation with warfarin or a NOAC is recommended for at least 2 months postcatheter ablation of AF. 1 C-EO Adherence to AF anticoagulation guidelines is recommended for patients who have undergone an AF ablation procedure, regardless of the apparent success or failure of the procedure. 1 C-EO Decisions regarding continuation of systemic anticoagulation more than 2 months postablation should be based on the patient's stroke risk profile and not on the perceived success or failure of the ablation procedure. 1 C-EO In patients who have not been anticoagulated prior to catheter ablation of AF or in whom anticoagulation with a NOAC or warfarin has been interrupted prior to ablation, administration of a NOAC 3 to 5 hours aer achievement of hemostasis is reasonable postablation. 2A C-EO Patients in whom discontinuation of anticoagulation is being considered based on patients values and preferences should consider undergoing continuous or frequent ECG monitoring to screen for AF recurrence. 2B C-EO Table 4. Anticoagulation Strategies: Pre-, During, and Post- Catheter Ablation of AF (cont'd) Recommendations COR LOE

Articles in this issue

Archives of this issue

view archives of HRS Guidelines Bundle (free trial) - Catheter and Surgical Ablation of Atrial Fibrillation