Anticoagulation after catheter ablation of atrial fibrillation guided by implantable cardiac monitors

Pacing and Clinical Electrophysiology : PACE
Christine S ZuernJürgen Schreieck

Abstract

Discontinuation of oral anticoagulation (OAC) after catheter ablation of atrial fibrillation (AF) is not recommended in patients with elevated CHADS2 scores. However, a low incidence of thromboembolic events is reported when OAC is stopped in these patients. We introduce an algorithm for discontinuation of OAC after ablation based on the AF burden documented by implantable cardiac monitors (ICM). Sixty-five patients with CHADS2 scores 1-3 free from AF 3 months after ablation (AF ablation [n = 49] or ablation of possible AF triggers [n = 16]) were included. One day after implantation of the ICM, OAC was stopped. Patients performed a daily interrogation of the ICM which was programmed to alarm the patient if daily AF burden exceeded 1 hour. Study end point was the first recurrence of a daily AF burden ≥1 hour or a thromboembolic event, which both triggered reinitiation of OAC. During a follow-up time of 32 ± 12 months (126 patient-years), 41 of the 65 patients (63%) had an AF burden <1 h/day and were able to stay off OAC. Twenty-one patients (32%) had to reinitiate OAC due to an AF burden ≥1 hour and three patients due to other reasons. No stroke, transitory ischemic attack, or other thromboembolic event was observed during follo...Continue Reading

References

Feb 26, 2008·Journal of the American College of Cardiology·Koonlawee NademaneeTachapong Ngarmukos
Mar 13, 2008·IEEE Transactions on Bio-medical Engineering·Shantanu SarkarRahul Mehra
Feb 18, 2010·Circulation. Arrhythmia and Electrophysiology·Gerhard HindricksUNKNOWN XPECT Trial Investigators
Feb 23, 2010·Journal of the American College of Cardiology·Sakis ThemistoclakisAndrea Natale
Jun 28, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Emile G DaoudUNKNOWN TRENDS Investigators
Aug 3, 2011·Journal of Cardiovascular Electrophysiology·Aurelie GuiotHakan Oral
Mar 6, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hugh CalkinsDavid Wilber
Aug 29, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paulus KirchhofA John Camm
Mar 19, 2014·Circulation·Michela BrambattiUNKNOWN ASSERT Investigators

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Citations

Sep 29, 2015·Pacing and Clinical Electrophysiology : PACE·Suneet MittalHelmut Pürerfellner
Nov 29, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Daniel A N MascarenhasBharat K Kantharia
Feb 20, 2016·Expert Review of Cardiovascular Therapy·R ProiettiA Verma
Nov 1, 2015·Pacing and Clinical Electrophysiology : PACE·Vineet KumarHarish Doppalapudi
May 12, 2016·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Suneet MittalRod S Passman
May 27, 2016·Pacing and Clinical Electrophysiology : PACE·Lukas Rc DekkerHelmut Pürerfellner
Dec 19, 2017·Journal of Atrial Fibrillation·Giuseppe CiconteCarlo Pappone
Feb 24, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Shaun GiancaterinoJonathan C Hsu
Oct 11, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hugh CalkinsUNKNOWN Document Reviewers:
Nov 23, 2016·Herzschrittmachertherapie & Elektrophysiologie·Simon WechselbergerMatthias Pohl
Dec 14, 2018·Expert Review of Medical Devices·Rafi SakhiSing-Chien Yap
Jan 8, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Wang-Yang YangChang-Sheng Ma
Apr 25, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Simon WechselbergerChristopher Piorkowski
Jan 1, 2021·Journal of Cardiovascular Electrophysiology·Naga Venkata K PothineniDavid S Frankel
Aug 1, 2021·Cardiac Electrophysiology Clinics·Suneet Mittal

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