心房颤动导管消融患者围术期短期启动新型口服抗凝药的有效性和安全性

目的探讨心房颤动患者在导管消融围术期短期启动新型口服抗凝药物治疗的有效性和安全性。方法回顾分析2016年12月至2017年6月在中国医学科学院阜外医院单中心行射频或冷冻导管消融治疗的非瓣膜性心房颤动患者97例(阵发性心房颤动72例和持续性心房颤动25例),根据抗凝情况分为两组:常规组34例,术前不间断口服达比加群抗凝3周以上;短期组65例,术前3 d启动达比加群抗凝。研究观察的主要终点事件为血管穿刺后至术后48 h发生的血栓和栓塞事件,次要终点事件包括大出血和(或)小出血事件。结果短期组和常规组的年龄[(59.0±9.1)岁比(58.8±10.4)岁,P=0.915]、CHA2DS2-VASc评分(2.5±2.0比2.5±1.8,P=0.956)、HAS-BLED评分(1.2±0.9比1.2±0.8,P=0.821)等基线指标差异均无统计学意义。两组术中活化凝血时间差异无统计学意义[(245.6±50.8)s比(234.4±50.9)s,P=0.308]。所有患者住院期间未记录到血栓和栓塞事件,并且无大出血事件。在小出血事件方面,短期组有3例腹股沟穿刺部位瘀斑或血肿,常规组有5例,但两组小出血事件发生率差异无统计学意义(4.6%比15.6%,P=0.110)。结论心房颤动患者于导管消融术前短期启动新型口服抗凝药物的方案有效且安全。     

经皮导管冷冻消融治疗心房颤动的研究进展

实验研究表明冷冻消融直接隔离肺静脉以及从左房组织隔离肺静脉，安全有效，不会出现肺静脉狭窄及血栓形成。临床研究亦表明，冷冻消融可减少潜在血栓形成的发生率，隔离肺静脉对控制大多数阵发性心房颤动是有效的，但该手术操作时间长，术后心房颤动发生率较高。冷冻球囊导管可能克服此缺点。     

心房颤动患者经导管射频消融术后的抗凝治疗

心房颤动(简称房颤)患者需要抗凝治疗,然而对于经导管射频消融术后的房颤患者,其抗凝策略尚存在争议。华法林可以降低患者的血栓栓塞发生率,也会相应的增加出血风险。对于中低危患者目前倾向于阿司匹林替代华法林用于术后的抗凝治疗,而目前对于高危患者虽有新的争议,但是仍倾向于使用华法林。新的抗凝药物的上市可能取代华法林。     

射频消融术治疗非瓣膜性心房颤动患者围术期的抗凝治疗

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。     

老年心房颤动患者的导管消融治疗进展

老年心房颤动(简称房颤)的导管消融治疗的有效性和安全性存在争议。最近研究表明在经验丰富的医学中心,老年房颤患者导管消融治疗的有效性和安全性与年轻患者相似,导管消融治疗逐渐成为老年房颤治疗的重要方法。     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

目的探讨持续性心房颤动（房颤）患者经导管射频消融术中不同抗凝方案与围术期血栓事件的关系。方法2004年7月至2007年10月连续收治行导管射频消融治疗的持续性房颤145例。所有患者术前均口服华法林抗凝,使国际标准化比率（INR）控制在2．0—3．0至少1个月。消融前停用华法林并用低分子肝素替代抗凝。2004年7月至2006年1月消融的患者（组Ⅰ）64例,完成房间隔穿刺后,静脉给予普通肝素5000U;2006年2月至2007年10月消融的患者（组Ⅱ）81例,完成房间隔穿刺后根据患者体重予以肝素（100U／kg）,两组患者消融术中每小时均追加肝素1000U。消融后行低分子肝素抗凝3d并口服华法林治疗至少3个月。结果组Ⅰ有4例患者于围术期出现血栓形成或血栓栓塞;组Ⅱ1例持续性房颤患者因消融后第3天自行停用华法林出现短暂性脑缺血发作,其余严格抗凝的患者均未出现血栓事件。组Ⅰ与组Ⅱ消融术前后达到抗凝要求的持续性房颤患者血栓事件发生率差异有统计学意义（4／64对0／80,P=0．037）。结论消融中根据患者体重调整抗凝强度可以显著减少持续性房颤患者围术期血栓事件并发症的发生。     

11家医院心房颤动患者口服抗凝药服药依从性的现状及影响因素

目的 调查心房颤动(简称房颤)患者口服抗凝药服药依从性的现状和时间变化趋势,探讨影响口服抗凝药服药依从性的因素.方法 前瞻性纳入2018年10月至2019年12月于全国8家三级医院和3家非三级医院就诊的口服抗凝药的房颤患者.所有患者入组后每月随访1次,通过药片计数法(PDC法:随访期间药物所覆盖的总天数除以患者的随访时...     

高龄心房颤动患者导管消融围术期不同抗凝方案的对比观察

目的：观察大于75岁的高龄心房颤动（房颤）患者围导管消融期三种抗凝方案的安全有效性。方法选取2011年7月到2013年12月行房颤导管消融治疗的高龄（＞75岁）房颤患者85例,术前常规华法林抗凝后经食管超声检查排除左心耳血栓,分为三组：传统抗凝组30例,消融前停用华法林,以低分子肝素桥接,术中用普通肝素抗凝,术后桥接低分子肝素联合华法林过渡到单用华法林;华法林持续使用组32例,围消融期正常使用华法林,术中使用普通肝素抗凝;新型口服抗凝药物组23例（达比加群组12例,利伐沙班组11例）,术前、术中同传统抗凝组,术后4h开始服用达比加群或利伐沙班抗凝。比较三组抗凝方案围术期到术后3个月的出血和栓塞事件发生率及其他并发症。结果传统抗凝组住院期间新发脑梗死1例,下肢血肿7例,假性动脉瘤1例,出院后3个月内内脏出血1例,小出血事件6例;华法林持续使用组院内下肢血肿4例,出院后3个月内小出血事件4例;新型口服抗凝药物院内下肢血肿2例,出院后无小出血事件。结论高龄房颤患者行导管消融治疗,总体安全有效。与传统抗凝治疗方案对比,持续使用华法林方案或采用新型口服抗凝药物能进一步降低出血并发症风险,并未增加血栓栓塞的风险。     

心房颤动导管射频消融静脉电隔离前后的抗凝治疗

探讨心房颤动 (简称房颤 )导管射频消融静脉电隔离前后的抗凝治疗 ,2 0 0 1年 8月到 2 0 0 4年 4月连续收治行射频消融治疗的阵发性房颤患者 15 6例 ,男 118例 ,女 38例 ,年龄 5 4± 10岁。术前行经食管心脏超声和 /或螺旋CT心脏成像检查排除心房内血栓 ;有高血压、糖尿病、一过性脑缺血发作 (TIA)或脑卒中史、或年龄大于 6 5岁的房颤患者术前华法林抗凝治疗 1个月 ;术后华法林抗凝治疗 1～ 3个月。结果 :前 4 0例患者在手术前后未按上述方法进行常规检查和规范抗凝治疗 ,术中脑栓塞引起失语和左上肢肌力下降 1例 ,术中和术后第三天TIA各 1例。 3例均伴有高血压 ,其中 1名合并有糖尿病。以后的 116例患者术前均行食管超声和 /或螺旋CT检查 ,手术前后及术中进行正规抗凝治疗 ,未再发生血栓栓塞事件 (3/ 4 0vs 0 / 116 ,P =0 .0 16 )。结论 :房颤患者在导管射频消融静脉电隔离手术前常规行经食管超声和 /或螺旋CT检查排除心房血栓 ,并在手术前后及术中进行规范抗凝治疗可有效预防手术相关血栓栓塞并发症。     

经皮导管冷冻消融治疗心房颤动的研究进展

实验研究表明冷冻消融直接隔离肺静脉以及从左房组织隔离肺静脉,安全有效,不会出现肺静脉狭窄及血栓形成。临床研究亦表明,冷冻消融可减少潜在血栓形成的发生率,隔离肺静脉对控制大多数阵发性心房颤动是有效的,但该手术操作时间长,术后心房颤动发生率较高。冷冻球囊导管可能克服此缺点。     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.     

持续性心房颤动射频消融术中不同抗凝方案与围术期血栓事件的关系

Objective The relationships between different anticoagulation methods during radiofre-quency catheter ablation(RFCA) of persistent/permanent atrial fibrillation (AF)and thromboembolic events in our center were evaluated. Methods From July 2004 to October 2007, RFCA was consecutively performed in 145 persistent/permanent AF patients. Anticoagulation with warfarin was administrated in all patients before op-eration for at least 1 month, with the international normalized ratio(INR) maintained between 2.0 and 3.0. Be-fore procedure,warfarin was discontinued and replaced by low molecular weight heparin(LMWH). After atrial septum puncture,a total of 5000 U tmfractioned heparin(UFH) were given to patients of group Ⅰ who under-went the ablation from July 2004 to January 2006,while patients of group Ⅱ who underwent the ablation from February 2006 to October 2007 were heparinized(100 U/Kg) according to their weights. During operation, 1000 U UFH was appended per hour. After procedure, LMWH was used for 3 days while warfarin was initiated at the same time and continued for at least 3 months. Results Four patients in group Ⅰ (64 patients ,51 men)experi-enced thrombosis or embolism during or after ablation. One female persistent AF patient in the group Ⅱ (81 pa-tients,67 men)who didn' t fulfill the anticoagulatian therapy experienced TIA after ablation. No thrombeembolic event was identified in other patients of group Ⅱ who fulfilled the anticoagulation therapy. The incidence of thromboembolic event of persistent/permanent AF patients who fulfilled the anticoagulation therapy in the group Ⅱwas lower than that of group Ⅰ (4/64 vs. 0/80, P = 0.037). Conclusions Strengthen the anticoagulation therapy according to patients' weights during radiofrequency ablation could significantly decrease the incidence of thromboembolic event in patients with persistent/permanent AF.