在一名已知患有II型肝素诱导的血小板减少症的患者进行肺静脉隔离期间，使用比伐卢定成功进行术中抗凝。
Successful intraprocedural anticoagulation with bivalirudin during pulmonary vein isolation in a patient with known heparin-induced thrombocytopenia type II.
作者信息
Bellmann Barbara, Nagel Patrick, Muntean Bogdan G
机构信息
Department of Cardiology, Charité Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
出版信息
J Arrhythm. 2016 Apr;32(2):154-5. doi: 10.1016/j.joa.2015.10.004. Epub 2015 Nov 19.
Abstract
We report the case of a 56-year-old female who presented with symptomatic paroxysmal atrial fibrillation. Anamnestic heparin-induced thrombocytopenia (HIT) type II was suspected, and a rapid diagnostic test showed antibodies against platelet factor 4. The heparin-induced platelet activation-assay was negative. Radiofrequency pulmonary vein isolation with intraprocedural anticoagulation using bivalirudin was ultimately performed. Dosing was controlled by monitoring the activated clotting time. Post-procedural blood tests were normal. There were no thromboembolic or bleeding events. Bivalirudin is a therapeutic option for anticoagulation during pulmonary vein isolation procedures in patients with a history of HIT type II.
摘要
我们报告了一例56岁有症状阵发性心房颤动的女性病例。怀疑有既往肝素诱导的II型血小板减少症（HIT），快速诊断检测显示存在抗血小板因子4抗体。肝素诱导的血小板活化试验为阴性。最终采用比伐卢定进行术中抗凝的射频肺静脉隔离术。通过监测活化凝血时间来控制剂量。术后血液检查正常。未发生血栓栓塞或出血事件。对于有II型HIT病史的患者，比伐卢定是肺静脉隔离术期间抗凝的一种治疗选择。
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