Study Design
After approval from our Institutional Review Board, data were collected on all consecutive patients from a single center that underwent left atrial ablation procedures performed between March 18th, 2018 and December 18th, 2018. As part of a quality improvement effort to standardize peri-procedural anticoagulation, a dosing protocol was initiated on August 9th, 2018. Outcomes before (usual care), and after protocol implementation (protocol guided) were confirmed by chart review and compared. All patients were evaluated after protocol initiation, and a retrospective comparison group (usual care) was collected on consecutive patients preceding protocol initiation. Demographic data, clinical characteristics and administered medications were recorded, as well as anticoagulation outcomes and procedural complications. Left atrial ablation was performed via transseptal access, and UFH was used for anticoagulation. If patients underwent more than one ablation within the data collection time period, only the first procedure data were included to eliminate dosing bias. During the data collection period, a total of 8 operators performed left atrial ablation procedures.