LAUSR

Q1 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 We appreciate the interest that Osmancik et al have expressed regarding our recently published study. We agree that periprocedural anticoagulation is an important and challenging issue. In general, our protocol described below is in keeping with others. All patients were treated with warfarin for at least 4 weeks before the procedure, with the target international normalized ratio between 2 and 3. Warfarin was discontinued, and patients were switched to low-molecular-weight heparin 3–5 days before the procedure at a daily dosage of 200 U/kg body weight. Transesophageal echocarcrdiography was performed 24 hours before the thoracoscopic procedure to exclude the presence of thrombus in the left atrial appendage. Low-molecular-weight heparin was held on the day of the procedure. During the procedure, patients were not anticoagulated to minimize bleeding risk. Anticoagulation therapy with low-molecular-weight heparin and warfarin was resumed after thoracoscopic ablation when the patient was admitted to the intensive care unit.