Construction of a predictive model of ACT for the first dose of heparin in patients with atrial fibrillation during radiofrequency ablation
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Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ,China

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R541.75

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    Abstract:

    Objective:To establish and validate a nomogram prediction model for the activated clotting time(ACT)measured 30 minutes after the first dose of heparin(30 min-ACT)in patients with atrial fibrillation undergoing radiofrequency ablation. Methods: From January 2020 to December 2022,1 090 patients with non-valvular atrial fibrillation who underwent catheter radiofrequency ablationinthe catheter room of the Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University were included. These patients were randomly divided into a training set and a testing set in a 3∶1 ratio. Kruskal-Wallis and Chi-square tests were used to compare the baseline characteristics of the two groups. LASSO regression and univariate and multivariate linear regression analyses were conductedto identify factors influencing 30 min-ACT. Based on these findings,a prediction model for 30 min-ACT with the first dose of heparin during radiofrequency ablation in patients with atrial fibrillation was established and evaluated. Results:Multivariate analysis suggested that stroke history,warfarin use,platelet count,prothrombin time(PT),baseline ACT,baseline ACT2 ,and first dose of heparin were independent predictors of first dose of heparin ACT during radiofrequency cardiac ablation in patients with atrial fibrillation. The resulting nomogram prediction model showed a certain level of accuracy(training set 65.9%,testing set 74.6%)and higher sensitivity(training set 77.4%,testing set 83.0%). Conclusion:The 30 min -ACT nomogram model,based on stroke history, warfarin ues,platelet count,PT,baseline ACT,baseline ACT2 ,and first dose of heparin,can predict the anticoagulant effect of the first dose of heparin in atrial fibrillation patients,providing valuable clinical guidance.

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FENG Jie, BAO Zhipeng, ZHOU Lihua, ZHAO Yafan, SONG Wen, ZHOU Yan, CHEN Sitong, QU Qiang, HE Ying. Construction of a predictive model of ACT for the first dose of heparin in patients with atrial fibrillation during radiofrequency ablation[J].,2024,(12):1715-1722.

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History
  • Received:September 19,2024
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  • Online: December 16,2024
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