CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2021 16_11-12_35910.15836/ccar2021.359Case reportsExtended AbstractThe nursing aspect in the application of anticoagulant therapy before and after ablation treatment for atrial fibrillationSestrinski aspekt kod primjene antikoagulantne terapije prije i nakon ablacijskog liječenja fibrilacije atrijahttps://orcid.org/0000-0002-3558-2034BarišićAntonela*https://orcid.org/0000-0001-6909-4197TvorekDominikKlinički bolnički centar Sestre milosrdnice, Zagreb, HrvatskaUniversity Hospital Centre „Sestre milosrdnice“, Zagreb, CroatiaAddress for correspondence: Antonela Barišić, Klinički bolnički centar Sestre milosrdnice, Vinogradska cesta 29, Zagreb, Croatia. / Phone: +385-1-3787-733 / E-mail: antonela.130697@gmail.com1020211611-1235935907092021140920212021Croatian Cardiac SocietyKLJUČNE RIJEČI: antikoagulantna terapijasestrinski aspektablacijsko liječenjeKEYWORDS: anticoagulant therapynursing aspectablation treatment
Atrial fibrillation (AF) is the most common persistent arrhythmia in the general population, with a prevalence of 2–4% in adulthood and a tendency to increase 2- to 3-fold in terms of life expectancy. (1) AF is the cause of numerous vascular complications, including cerebrovascular stroke (20-30% ischemic stroke or 10% cryptogenic stroke), heart failure due to increased ventricular rate (in 20-30% of FA patients), vascular dementia, and other general disorders such as depression or frequent hospitalizations. (2) The generally accepted treatment for vascular complications is warfarin, and more recently, new oral anticoagulants, which can cause hemorrhage. (3)
The decision on the type of treatment approach is made on the basis of symptoms, type of cardiac treatment (ECG, the holter ECG, echocardiography, blood tests), the physician’s decision and the patient’s consent to the proposed treatment. Catheter atrial fibrillation ablation is an invasive procedure during which controlled local heating or cooling of the tissue is performed to target the source of the arrhythmia. This procedure contributes greatly to the improvement of symptomatology in patients and supports further progress in the treatment of AF. Before performing ablation treatment, it is important to mentally and physically prepare the patient for the procedure. The physical preparation of the patient includes, among other things, TEE (the issue of thrombus in the auricle) and the application of therapy (anticoagulants). It is very important when acquiring a medical history, to acquire information on which anticoagulant drug is used and how long the patient has been using it. (2)
Postprocedural care involves monitoring the cognitive status, the presence of neurological outbursts, monitoring the puncture site, the presence of chest pain, throat, back, blood pressure control, ECG, patient mobilization, and monitoring of complications. When caring for a patient, it is important to mention the holistic approach and the principle of individual approach to each patient. The aim of this lecture is to present the measures implemented in nursing care before and after ablation treatment. It is important to be aware of the connection between anticoagulant therapy and ablation therapy. The nurse as part of a multidisciplinary team has an important role in the prevention of complications, but also in their early detection, which greatly affects the quality of life of patients.
LITERATUREChughSSHavmoellerRNarayananKSinghDRienstraMBenjaminEJWorldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. . 2014 February 25;129(8):837–47. 10.1161/CIRCULATIONAHA.113.00511924345399HindricksGPotparaTDagresNArbeloEBaxJJBlomström-LundqvistC2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. . 2021 February 1;42(5):373–498. 10.1093/eurheartj/ehaa61232860505Bernat R. Farmakoterapija fibrilacije atrija. Medicus. 2010;19(2_Kardiologija):203-214. Available at: https://hrcak.srce.hr/65108