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. 2016 Apr;32(2):154-5.
doi: 10.1016/j.joa.2015.10.004. Epub 2015 Nov 19.

Successful intraprocedural anticoagulation with bivalirudin during pulmonary vein isolation in a patient with known heparin-induced thrombocytopenia type II

Barbara Bellmann  1 , Patrick Nagel  1 , Bogdan G Muntean  1
Affiliations

Successful intraprocedural anticoagulation with bivalirudin during pulmonary vein isolation in a patient with known heparin-induced thrombocytopenia type II

Barbara Bellmann et al. J Arrhythm. 2016 Apr.

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.

Keywords: Activated clotting time; Atrial fibrillation; Bivalirudin; Heparin induced thrombocytopenia type II; Pulmonary vein isolation.

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