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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Conventional antithrombotic approaches

J J Ferguson1

  • 1Cardiology Research Department, St. Luke's Episcopal Hospital, Houston, TX 77225, USA.

American Heart Journal
|September 1, 1995
PubMed

Insights

Achieving adequate anticoagulation during percutaneous transluminal coronary angioplasty (PTCA) is crucial. Titrating heparin to specific activated clotting time (ACT) levels, like >275-300s (HemoTec) or >350-400s (Hemochron), can help prevent complications.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Hematology

Background:

  • Thrombus formation during percutaneous transluminal coronary angioplasty (PTCA) increases risks of abrupt closure and procedural failure.
  • Ensuring adequate anticoagulation during PTCA is critical but subject to debate.
  • Low activated clotting time (ACT) has been linked to PTCA complications.

Purpose of the Study:

  • To evaluate the role of anticoagulation in preventing PTCA complications.
  • To provide recommendations for optimal anticoagulation strategies during PTCA.

Main Methods:

  • Review of existing studies on heparin anticoagulation and PTCA outcomes.
  • Analysis of the relationship between ACT levels and PTCA complication rates.
  • Evaluation of different ACT monitoring devices and target ranges.

Main Results:

  • No prospective studies definitively prove one ACT threshold superior to another.
  • Current data suggest targeting HemoTec ACT >275-300 seconds or Hemochron ACT >350-400 seconds.
  • Weight-based heparin dosing does not ensure predictable anticoagulation but may prevent overdose in lighter patients.

Conclusions:

  • Titrating anticoagulation to specific ACT levels is recommended for patients undergoing PTCA.
  • Monitoring ACT is essential for managing heparin therapy and minimizing procedural risks.
  • Further prospective studies are needed to establish definitive ACT thresholds.

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