Earticle

초록

영어

Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the 1st-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were 2.1 ± 0.6 in Group A and 2.2 ± 0.7 in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: ‘omission in taking medication, stressfulness and headache, ‘increased intake of high vitamin K foods’, ‘lifestyle change of increased physical activities’, and ‘increase of food-intakes’. To the contrary, 36 cases of increased INR were: ‘reduce of food-intake’, ‘use of non-prescription drugs’, ‘reduction in physical activities’, and ‘excessive restriction on food-intake’, consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation

목차

Abstract
 연구방법
  대상환자
  조사방법
  통계처리
 연구결과
  연구대상 환자
  Warfarin의 사용량 및 기간
  시술 전·후 INR값
  ACS횟수 및 INR 값 변동요인
 고찰
 참고문헌

키워드

저자

• 김수현 [ Suhyun Kim | 가톨릭대학교 여의도성모병원 약제팀 ]
• 안성심 [ Sung Shim An | 가톨릭대학교 서울성모병원 약제부 ]
• 김순주 [ SoonJoo Kim | 가톨릭대학교 서울성모병원 약제부 ]
• 방준석 [ Joon Seok Bang | 가톨릭대학교 서울성모병원 약제부 ] Correspondence to
• 나현오 [ Hyen Oh La | 가톨릭대학교 서울성모병원 약제부, 가톨릭대학교 의과대학 약리학교실 ] Correspondence to

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  한국임상약학회지 [Korean Journal of Clinical Pharmacy]

• 간기

  계간

• pISSN

  1226-6051

• 수록기간

  1991~2026

• 등재여부

  KCI 등재

• 십진분류

  KDC 518 DDC 615