Anticoagulation during Procedure
Baseline activated clotting time (ACT) was measured before an initial
bolus injection of unfractionated heparin (UFH). Then, a bolus of UFH
(80-120 IU/kg) was administered. ACT was measured every 10-20 minutes
after the first UFH shot, and additional UFH boluses (20-60 IU/kg) were
administered before trans-septal puncture in order to reach optimal ACT
(>300 sec) for AF ablation.10 The time
from the baseline ACT measurement and the amount of UFH to achieve the
optimal ACT were calculated. During the procedure, ACT was measured
every 20-30 minutes; additional UFH boluses were intermittently
administered to maintain the ACT >300 sec. All left atrial
sheaths were regularly flushed with heparinized saline to avoid clot
formation within the sheaths. The total amount of UFH required for the
procedure was also calculated. After the procedure, UFH was neutralized
with protamine sulfate