{
  "abstract": "Background: Activated clotting time (ACT) is used to monitor unfractionated heparin (UFH) during left atrial (LA) ablation procedures. Inadequate anticoagulation increases thromboembolic risk, while excessive UFH may increase bleeding. ACT can be sampled from a femoral venous sheath (ACTFV) or from oxygenated blood within the LA (ACTLA). The influence of sampling site on ACT values during atrial fibrillation ablation is unknown.\n\nMethods: In this prospective observational study, consecutive patients undergoing cryoballoon pulmonary vein isolation received intravenous UFH. ACT was sampled sequentially from the LA and from a femoral venous sheath. All samples were analyzed on the same point-of-care ACT machine. Non-inferiority of LA relative to femoral venous sampling was tested against a 30-s margin, with agreement assessed by Cohen's kappa at 300 s and Bland-Altman analysis.\n\nResults: Sixty-two patients were recruited (42% female; CHA2DS2-VASc 3.1 ± 1.8); 61 had paired samples. Mean ACTLA was 365 ± 83 and ACTFV was 359 ± 65 s (p = 0.455). The mean paired difference (ACTLA − ACTFV) was +6.1 s (upper one-sided 97.5% confidence limit +22.4 s), below the 30-s non-inferiority margin (p = 0.002). Bland-Altman limits of agreement were − 119 to +131 s, with significant proportional bias (β = 0.288, p = 0.017). Dichotomized at 300 s, Cohen's kappa was 0.586 (moderate concordance).\n\nConclusions: ACT sampling from the LA was non-inferior to femoral venous sampling within a 30-s margin, supporting the use of either sampling site during LA ablation. Despite notable variability between paired measurements, unexpected ACT values should prompt repeat testing rather than be attributed to the sampling site.",
  "abstract_shown": true,
  "affiliations": [
    "Technion Israel Institute of Technology, The Ruth and Bruce Rappaport Faculty of Medicine, Technion City, Haifa, Israel",
    "Division of Cardiovascular Medicine, Hillel Yaffe Medical Center, Hadera, Israel",
    "Clinical Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Gilad Margolis"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Kirill Berezhnoi"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ofir Goldhaber"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ofer Kobo"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Mark Kazatsker"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Ma'anit Shapira"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Rami Abu-Fanne"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ariel Roguin"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Eran Leshem"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ecaapyxj1h3vh.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ahjo.2026.100995",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735004/",
  "id": "ecaapyxj1h3vh",
  "issns": [
    "2666-6022"
  ],
  "landing_url": "https://doi.org/10.1016/j.ahjo.2026.100995",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Paper"
    ],
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7223440455",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S2666602226002855/pdf",
  "pmcid": "PMC13735004",
  "pmid": "42990681",
  "published": "2026-10-24",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/ecaapyxj1h3vh.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:20:47Z",
      "native_id": "PMC13735004",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.ahjo.2026.100995"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Impact of sampling site on Activated Clotting Time (ACT) during cryoballoon ablation: Left atrium vs femoral sheath",
  "title_text": "Impact of sampling site on Activated Clotting Time (ACT) during cryoballoon ablation: Left atrium vs femoral sheath",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:20:47Z",
  "url": "https://research.draconitic.com/paper/ecaapyxj1h3vh",
  "venue": "American Heart Journal Plus: Cardiology Research and Practice",
  "versions": []
}