Monitoring of activated clotting time during interventional cardiology and cardiosurgical procedures

Activated clotting time (ACT) is a critical parameter for assessing the degree of anticoagulation during interventionalcardiology and cardiac surgery procedures, particularly in settings involving high doses of unfractionated heparin (UFH). Effective monitoring of ACT helps minimize the risk of thrombotic and bleeding complications by enabling real-time adjustments in anticoagulant therapy. This paper reviews the physiological basis of ACT measurement, its clinical relevance, and the techniques used for intraoperative monitoring. We discuss current studies, emphasizing the importance of individualized ACT targets depending on the type of procedure. Furthermore, challenges such as variability in ACT response and limitations of current testing methods are analyzed. Activated clotting time is quite simple, quick, and therefore does not prolong the time of invasive cardiology procedures. It is a widely accepted tool adapted to everyday clinical practice, thanks to which we can administer adequate doses of UFH during procedures. Regardless of the results obtained by the authors, it is recommended that the ACT falls within between 300 and 400 s, which is a safe range that contributes to the reduction of complications— both excessive bleeding and thrombotic complications.