Anticoagulant therapy analysis and pharmaceutical monitoring in an elderly patient with atrial fibrillation undergoing catheter ablation: a case report
HUANG Min-yan CHEN Xia▲
Department of Pharmacy, the First People′s Hospital of Nantong, Jiangsu Province, Nantong 226001, China
Abstract:In this paper, one elderly atrial fibrillation patient with anticoagulant therapy undergoing catheter ablation was given pharmacological monitoring and guidance from the causes of Warfarin international standardized ratio (INR)fluctuations, the perioperative period and the formulation of long-term anticoagulation programs, the conversion between traditional oral anticoagulants and new oral anticoagulants, and precautions for taking anticoagulants.Through active pharmacological monitoring and guidance by the clinical pharmacist, there were no thrombotic and hemorrhagic adverse events during catheter ablation, and the anticoagulation strategy was adjusted to a new oral anticoagulant: Dabigatran, to ensure sufficient anticoagulant efficacy and also reduce the risk of bleeding.The clinical pharmacist and the medical care providing proper pharmacological management of perioperative anticoagulation for such elderly patients,not only ensures the rationality of anticoagulation treatment, but also ensures the safety and continuity of anticoagulation.
Guo Y,Tian Y,Wang H,et al.Prevalence,incidence,and lifetime risk of atrial fibrillation in China:new insights into the global burden of atrial fibrillation[J].Chest,2015,147(1):109-119.
Camm AJ,Lip GY,De Caterina R,et al.2012 focused update of the ESC Guidelines for the management of atrial fibrillation:an update of the 2010 ESC Guidelines for the management of atrial fibrillation.Developed with the special contribution of the European Heart Rhythm Association[J].Eur Heart J,2012,33(21):2719-2747.
January CT,Wann LS,Alpert JS,et al.2014AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:A report of the American College of Cardiology/American Heart Assocation Task Force on Practice Guidelines and the Heart Rhythm Society[J].J Am Coll Cardiol,2014,64(21):e1-e76.