Evidence map›Paper›PMID 25471944›Full record

ArticleHeart and vessels2016

Influence of the concomitant use of heparin on the effects of warfarin during catheter ablation for atrial fibrillation.

Keiichi Inada, Seiichiro Matsuo, Ken-Ichi Tokutake, Ken-Ichi Yokoyama, Mika Hioki, Ryohsuke Narui, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Michifumi Tokuda and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in Heart and vessels, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 85% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Keiichi InadaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan. inadi@jikei.ac.jp.
Seiichiro MatsuoDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Ken-Ichi TokutakeDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Ken-Ichi YokoyamaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Mika HiokiDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Ryohsuke NaruiDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Keiichi ItoDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Shin-Ichi TanigawaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Seigo YamashitaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Michifumi TokudaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Kenri ShibayamaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Satoru MiyanagaDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Ken-Ichi SugimotoDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Michihiro YoshimuraDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Teiichi YamaneDivision of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.
Jikei University School of Medicine · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Warfarin is widely used to perform catheter ablation for atrial fibrillation (AF). Heparin is usually administered during this procedure to prevent thromboembolic events, while protamine is used to reduce the incidence of bleeding complications. The purpose of this study was to investigate the influence of heparin and protamine administration on the effects of warfarin and its safety. The subjects included 226 AF patients (206 males, 54.9 ± 9.1 years, paroxysmal/persistent AF: 118/108) undergoing AF ablation with the discontinuation of warfarin administration over 2 days. Heparin was administered to achieve an activated clotting time (ACT) above 300 s during the procedure. Several parameters of the coagulation status, including the prothrombin time international normalized ratio (PT-INR) and ACT values, measured immediately before and after protamine infusion were compared. The mean value of PT-INR prior to ablation was 1.9 ± 0.6. At the end of the procedure, the mean ACT and PT-INR values were 348.0 ± 52.9 and 2.9 ± 0.7, respectively. Following the infusion of 30 mg of protamine, both the ACT and PT-INR values significantly decreased, to 159.6 ± 31.0 (p < 0.0001) and 1.6 ± 0.3 (p < 0.0001), respectively. No cases of symptomatic cerebral infarction were observed, although femoral hematomas developed in 17 (7.5 %) of the patients without further consequence. The concomitant use of heparin augments the effect of warfarin. Meanwhile, protamine administration immediately reverses both the ACT and PT-INR, indicating the applicability of protamine for AF ablation in patients under the mixed administration of heparin and warfarin.

Indexed as

Catheter AblationAdultAgedAnticoagulantsAtrial FibrillationBlood CoagulationBlood Coagulation TestsBlood Loss, SurgicalDrug Administration ScheduleDrug MonitoringFemaleHeparinHeparin AntagonistsHumansMaleMiddle AgedAnticoagulantsHeparinHeparin AntagonistsProtaminesWarfarinAnticoagulationAtrial fibrillationCatheter ablationProtamineWarfarin

Identifiers

PMID25471944
OpenAlexW2062790530

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.