心房颤动射频消融术中ACT指导阶梯性抗凝方案与经验性抗凝方案的比较：一项倾向性评分匹配的观察性研究

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【Abstract】ObjectiveThisstudyaims todeterminewhichregimencanachievethetherapeutictargetofactivatedcoagulationtime （ACT）moredlyfeldtielybompigtcalticoalantecoedddoesedelii thestepwiseanticoagulantregimenbasedonbaselineACTvalues.MethodsAtotalof8Opatientsundergoingradiofrequencyablatiofor atrialfibrillioaesledHspialfngdalUvesieoldstepsegopdptre AfiliatedSzouHospitalofNanjingMedicalUniversityereicudedastempicalgroup.aselinCvalues，ACTtargeacieet rateat5miesCagentatettesgeteveetateatndotalpeati dosagewerecomparedbetweentetwogroups.ResultsThCtargetachievementrateat15minutesfterthefistintravenousijectiof heparin was numerically higher in the stepwise group（51. 2% ）compared to the empirical group（45. 0% ），but this difference was not statistically significant（ P=0.429 ）. The ACT target achievement rate at 30 minutes （ 75.0% ）and ACT target achievement rate at 6O minutes （204 （85.0%） of the stepwise group after atrial septal puncture were significantly higher than those of the empirical group（ 56.3% and 62.5% ， respectively， P=0.013 and P=0.001 ）. The total intraoperative heparin dosage in the stepwise group was significantly higher than that in the empirical group（ P=0.030 ）.Observation of acute complications within72hours after surgery showedno significant statistical difference in bleeding between the two groups （ P=0 . 468）.In terms of embolic events，there was 1 case（1. 3% ）of acute cerebral infarction in the empiricalgroup，hilenoclinicaltromboemboliceventswreobservedinthestepwisegroup.ConclusionThestepwiseanticoaglation regimenbasedobselieCTvauesisoreaidandfectiveinchievigACTterapeuticargtcompaedtompiicalticoalatio regimen.Howevetaoeatieepaosutiooftpwetcoalatioisantlyigrantal anticoagulation regimen，indicating the need for individualized risk benefit assessment in clinical practice.

【Keywords】 Atrial fibrillation;Radiofrequency ablation;Heparin;Activated coagulation time

心房颤动（房颤）是最常见的心律失常之一，其患病率随年龄增加而升高[1]。（剩余10462字）