Evidence map›Paper›PMID 29500504›Full record

ArticlePediatric cardiology2018

Development and Implementation of a Standardized Heparin Protocol for Left-Sided Pediatric Electrophysiology Procedures.

Emily F Moore, Jennifer Pak, Christa Jefferis-Kirk, Arlene Armatage, Richard A Kronmal, Jack C Salerno, Matthew D Files

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Article in Pediatric cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

7 authors.

Emily F MooreDivision of Cardiology and Cardiac Surgery, Heart Center at Seattle Children's Hospital, 4800 Sand Point way NE Mail Stop RC 2.820, Seattle, WA, 98105, USA. emily.moore@seattlechildrens.org.
Jennifer PakDepartment of Pharmacy, Seattle Children's Hospital, 4800 Sand Point Way NE, Mail stop BM.5.420, Seattle, WA, 98105, USA.
Christa Jefferis-KirkDepartment of Pharmacy, Seattle Children's Hospital, 4800 Sand Point Way NE, Mail stop BM.5.420, Seattle, WA, 98105, USA.
Arlene ArmatageDivision of Cardiology and Cardiac Surgery, Heart Center at Seattle Children's Hospital, 4800 Sand Point way NE Mail Stop RC 2.820, Seattle, WA, 98105, USA.
Richard A KronmalDepartment of Biostatistics, Collaborative Health Studies Coordinating Center, University of Washington, Bldg. 29, 6200 NE 74th St., Seattle, WA, 98115, USA.
Jack C SalernoDivision of Pediatric Cardiology, Department of Pediatrics, University of Washington, 1959 NE Pacific St., Health Sciences Bldg., Seattle, WA, 98195, USA.
Matthew D FilesDivision of Pediatric Cardiology, Department of Pediatrics, University of Washington, 1959 NE Pacific St., Health Sciences Bldg., Seattle, WA, 98195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Heparin is used to decrease the risk of thromboembolic complications during electrophysiology studies (EPS); however, there is wide practice variation and minimal evidence to guide heparin dosing, particularly in pediatric patients. This study retrospectively analyzed heparin dosing and response, measured via activated clotting time (ACT), in patients undergoing EPS and used these data (pre-protocol cohort, n = 40), as well as guidance from available literature to implement a standardized heparin protocol (phase 1, n = 43). We utilized quality improvement methodology to refine this protocol (phase 2, n = 40) to improve therapeutic heparin response. Prior to the protocol, patients achieved therapeutic ACT levels (250-350 s) only 35% of the time which improved to 60% during phase 1 (p < 0.05) and to 73% during phase 2 (p < 0.001 compared to pre-protocol). There were no thromboses or significant adverse events in any group. These results demonstrate the effectiveness of a standardized heparin protocol in achieving effective antithrombotic therapy during left-sided pediatric EPS.

Indexed as

AdolescentAnticoagulantsCatheter AblationChildCohort StudiesDose-Response Relationship, DrugElectrophysiological PhenomenaFemaleHeparinHumansMaleRetrospective StudiesThromboembolismWhole Blood Coagulation TimeYoung AdultAnticoagulantsHeparinAnticoagulationArrhythmiaCatheter ablationChildrenElectrophysiological proceduresHeparinPediatric cardiologyRadiofrequency ablation

Identifiers

PMID29500504

What OpenQuestion holds

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Registered trials

None linked

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.