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经导管射频消融治疗心房颤动的患者越来越多,为减少血栓的发生,围术期的抗凝治疗不容忽视。目前抗凝的主要药物为肝素、低分子肝素和华法林,具体应用方法国内外已逐渐规范,但国内术中肝素剂量偏小,缺乏激活凝血时间的指导,是否安全有待进一步研究。另外术后华法林应用时间、低分子肝素是否能替代华法林抗凝,需大规模临床试验证实。新型口服抗凝药是否能真正应用于临床,值得期待。
Transcatheter radiofrequency ablation of atrial fibrillation in patients with more and more, in order to reduce the incidence of thrombosis, perioperative anticoagulant therapy can not be ignored. The main anticoagulant drugs heparin, low molecular weight heparin and warfarin, the specific application methods have gradually standardized at home and abroad, but the domestic intraoperative heparin dose is too small, the lack of activation of coagulation time guidance, is safe to be further studied. Another postoperative warfarin application time, low molecular weight heparin can replace warfarin anticoagulation, to be confirmed by large-scale clinical trials. Whether the new oral anticoagulant can be truly applied in clinic is worth the wait.