PMID- 24938637
OWN - NLM
STAT- MEDLINE
DCOM- 20150616
LR  - 20211021
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 41
IP  - 2
DP  - 2014 Nov
TI  - Periprocedural outcomes of prophylactic protamine administration for reversal of 
      heparin after cryoballoon ablation of atrial fibrillation.
PG  - 129-34
LID - 10.1007/s10840-014-9922-y [doi]
AB  - PURPOSE: The aim of this study was to investigate the efficacy and the safety of 
      prophylactic use of protamine in a series of heparinized patients having 
      undergone cryoballoon (CB) ablation for atrial fibrillation (AF). METHODS: From 
      October 2013 to January 2014, 54 consecutive patients received protamine after CB 
      ablation to neutralize unfractionated heparin (UFH) effects. They were 
      prospectively included in this study and compared to a control group of 53 
      patients who underwent CB ablation without receiving protamine. RESULTS: A total 
      of 54 consecutive patients (33 male, 61%; mean age, 58 +/- 12 years) were included. 
      Twenty-one patients (39%) presented with hypertension, 17 (31%) with 
      dyslipidemia, and 4 (7%) with diabetes. Five patients (9%) had a previous episode 
      of ischemic stroke. Mean protamine dose was 68 +/- 22 mg. No adverse reaction to 
      protamine was observed. Among patients having received protamine, one (2%) 
      experienced a cardiac tamponade requiring non-surgical drainage. No patient 
      having undergone protamine administration experienced vascular complications. 
      Conversely, the group of patients not treated with protamine had a significantly 
      higher incidence of vascular complications as compared to patients having 
      undergone protamine infusion (11 vs 0%, p = 0.01). CONCLUSIONS: Reversing effects 
      of UFH by the means of protamine administration appears to be safe after CB 
      ablation for AF. It can allow in-laboratory sheath removal with potentially less 
      vascular complications and no increase of thromboembolic risk. Larger randomized 
      studies are needed in order to confirm our findings.
FAU - Conte, Giulio
AU  - Conte G
AD  - Heart Rhythm Management Center, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, 
      Belgium, giulioconte.cardio@gmail.com.
FAU - de Asmundis, Carlo
AU  - de Asmundis C
FAU - Baltogiannis, Giannis
AU  - Baltogiannis G
FAU - Di Giovanni, Giacomo
AU  - Di Giovanni G
FAU - Ciconte, Giuseppe
AU  - Ciconte G
FAU - Sieira, Juan
AU  - Sieira J
FAU - Saitoh, Yukio
AU  - Saitoh Y
FAU - Wauters, Kristel
AU  - Wauters K
FAU - Mugnai, Giacomo
AU  - Mugnai G
FAU - Julia, Justo
AU  - Julia J
FAU - Irfan, Ghazala
AU  - Irfan G
FAU - Levinstein, Moises
AU  - Levinstein M
FAU - Cotino-Moreno, Hugo Enrique
AU  - Cotino-Moreno HE
FAU - Chierchia, Gian-Battista
AU  - Chierchia GB
FAU - Brugada, Pedro
AU  - Brugada P
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20140618
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin Antagonists)
RN  - 0 (Protamines)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/administration & dosage/adverse effects
MH  - Atrial Fibrillation/diagnosis/*drug therapy/surgery
MH  - Case-Control Studies
MH  - Catheter Ablation/instrumentation/*methods
MH  - Electrocardiography/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heparin/administration & dosage/adverse effects
MH  - Heparin Antagonists/*administration & dosage
MH  - Humans
MH  - Intraoperative Care/methods
MH  - Male
MH  - Middle Aged
MH  - Postoperative Care/methods
MH  - Postoperative Complications/prevention & control
MH  - Primary Prevention/methods
MH  - Prospective Studies
MH  - Protamines/*administration & dosage
MH  - Statistics, Nonparametric
MH  - Thrombosis/*prevention & control
MH  - Treatment Outcome
EDAT- 2014/06/19 06:00
MHDA- 2015/06/17 06:00
CRDT- 2014/06/19 06:00
PHST- 2014/04/17 00:00 [received]
PHST- 2014/05/13 00:00 [accepted]
PHST- 2014/06/19 06:00 [entrez]
PHST- 2014/06/19 06:00 [pubmed]
PHST- 2015/06/17 06:00 [medline]
AID - 10.1007/s10840-014-9922-y [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2014 Nov;41(2):129-34. doi: 
      10.1007/s10840-014-9922-y. Epub 2014 Jun 18.