Open Access

ARTICLE

Low molecular weight heparin as an anticoagulation strategy for left-sided ablation procedures

Karen Hinsley, Margaret Evans-Langhorst, Courtney Porter, Stephanie Chandler, Christina VanderPluym, John Triedman, Vassilios J. Bezzerides

Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA

* Corresponding Author: Vassilios J. Bezzerides, Department of Cardiology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115. Email: . org

Congenital Heart Disease 2018, 13(2), 222-225. https://doi.org/10.1111/chd.12551

Abstract

Objective: This quality improvement study was implemented to demonstrate consistent and reliable post procedure anticoagulation for patients undergoing left-sided ablations. We evaluated the safety and efficacy of anticoagulation practice during a transition from anticoagulation with overnight infusion of unfractionated heparin to a single subcutaneous injection of low molecular weight heparin.
Methods: Outcomes for patients who received unfractionated heparin from January 2014 to October 2014, were compared with outcomes of patients who received low molecular weight heparin from October 2014 to October 2015. Complications prepractice and postpractice change were documented and compared to establish confidence in the practice change and confirm the safety of the anticoagulation therapy management.
Results: There were no differences in the type or frequency of complications/adverse events demonstrated between the patients who had received unfractionated heparin for anticoagulation prophylaxis and those who received low molecular weight heparin. No thromboembolic events were reported or documented with either anticoagulation strategy. After confidence in the safety and efficacy of the practice change was established, a decision was made to discharge patients home the same day as there procedure, effectively reducing inpatient bed days and overall costs.
Conclusion: Administration of low molecular weight heparin provides predictable anticoagulation and equally safe as unfractionated heparin when administered to patients post left-sided ablation. A secondary gain has been reduction of procedural costs by elimination of the previously required inpatient observation stay.

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