Procedural Characteristics
The majority of left atrial ablation procedures evaluated were for
treatment of atrial fibrillation. Of the 100 patients in the usual care
ablation cohort, 85 received treatment for atrial fibrillation, 4 for
left sided accessory pathway, and 12 for left atrial tachycardia. Of the
100 patients in the protocol guided ablation cohort, 93 received
treatment for atrial fibrillation, 5 for left sided accessory pathway,
and 2 for left atrial tachycardia.
The average number of ACT’s drawn per procedure were similar between
each cohort, as an average of 5.9 ± 2.4 were drawn in the usual care
cohort, as opposed to 5.7 ± 2.4 in the protocol guided cohort. The
average time to ACT after initial heparin bolus was 25 ± 13 minutes in
the usual care, and 25 ± 13 minutes in the protocol guided cohorts.
There was a difference in timing of heparin administered with regard to
transseptal puncture, as heparin was administered prior to transseptal
puncture in the usual care cohort at a lower rate (77%), compared the
protocol guided arm (94%). The initial heparin bolus was split (before
and after transseptal puncture) in a high proportion in the usual care
cohort (30%), when compared to the protocol guided cohort (13%).