Arrhythmias & electrophysiologyMeta-analysis
Activated clotting time platforms matter: Evidence gaps and real-world variability in anticoagulation targets during left atrial ablation
- systematic review
- international physician survey
Authors' conclusion
Available cross-validation data indicate substantial differences among ACT platforms. Real-world heparin administration strategies and ACT targets vary markedly by platform. These findings challenge the assumption of universal ACT targets and highlight the need for platform-specific interpretation.
Study context
- Population
- Studies directly comparing activated clotting time (ACT) values across different measurement platforms during left atrial ablation; electrophysiologistselectrophysiologists completing the survey, systematic review identified 4 electrophysiology-specific studies
- Participants
- 164 participants
- Comparison
- ACT values across different measurement platforms during left atrial ablation
Pooled result
As reported in the abstract
Simultaneously measured ACT values across platforms
mean paired differences
50-60 seconds
discrepancy at ACT targets of 300-350 seconds
15%-25%
Further pooled results
Most used ACT platforms
Survey respondents by region
- from Europe
- 82%
- from North America
- 13%
Target ACT ranges and heparin dosing strategies by platform
- higher ACT targets and higher weight-based heparin doses were most frequently reported with Hemochron
- lower targets and doses were more common with i-STAT
- users of Medtronic showed an intermediate pattern
- Nearly one-third of respondents reported modifying heparin dosing after switching ACT platforms
Original publication
Activated clotting time platforms matter: Evidence gaps and real-world variability in anticoagulation targets during left atrial ablation. Heart Rhythm. Published 7 March 2026. doi:10.1016/j.hrthm.2026.03.003
Summarised from the published abstract; every number is checked against it