* Requiring transfusion or surgery
The overall complication rate using an open tip irrigated catheter and an ACT of less than 250 seconds (average 224 seconds) compares favourably with rates of 2.7 to 3.9% reported in recent surveys. The authors noted that women tended to have higher blood levels of heparin and higher ACTs than men for equivalent doses of heparin. This could explain why women tend to have more bleeding complications during catheter ablation and calls for greater care in adjusting heparin infusion when women are ablated.
Winkle, RA, et al. Safety of lower activated clotting times during atrial fibrillation ablation using open irrigated tip catheters and a single transseptal puncture. American Journal of Cardiology, Vol. 107, No. 5, March 1, 2011, pp. 704-08
Editor's comment: The finding that ACT can be safely decreased when using an open tip irrigated catheter is obviously of significant importance and its general implementation should help reduce procedure-related bleeding complications, especially in female ablatees.