Atrial Fibrillation in a Patient with Heparin-induced Thrombocytopenia Successfully Treated by Radiofrequency Catheter Ablation Using a Direct Thrombin Inhibitor

Intern Med. 2022 Sep 15;61(18):2747-2751. doi: 10.2169/internalmedicine.9288-21. Epub 2022 Feb 19.

Abstract

A 74-year-old man was admitted to our hospital to undergo radiofrequency catheter ablation (RFCA) of persistent atrial fibrillation (AF). We found that he had a history of heparin-induced thrombocytopenia (HIT). Thus, a direct thrombin inhibitor, Argatroban Hydrate (Argatroban®), was used instead of heparin as anticoagulation therapy during the RFCA procedure. Finally, the AF was successfully treated by RFCA without any complications. Given these findings, the direct thrombin inhibitor Argatroban® may be effective and feasible for anticoagulation therapy during RFCA procedures for AF in patients with HIT, such as the present case.

Keywords: atrial fibrillation; direct thrombin inhibitor; heparin-induced thrombocytopenia; radiofrequency catheter ablation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antithrombins / therapeutic use
  • Arginine / analogs & derivatives
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / drug therapy
  • Atrial Fibrillation* / surgery
  • Catheter Ablation* / methods
  • Heparin / adverse effects
  • Humans
  • Male
  • Pipecolic Acids
  • Sulfonamides
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / complications
  • Thrombocytopenia* / drug therapy
  • Treatment Outcome

Substances

  • Antithrombins
  • Pipecolic Acids
  • Sulfonamides
  • Heparin
  • Arginine
  • argatroban