Catheter ablation for atrial fibrillation on uninterrupted direct oral anticoagulants: A safe approach

Pacing and Clinical Electrophysiology : PACE
V SawhneyR J Hunter

Abstract

Current consensus guidelines suggest direct oral anticoagulants (DOACs) are interrupted periprocedurally for catheter ablation (CA) of atrial fibrillation (AF). However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. This was a single-center, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinized prior to transseptal puncture with a target-activated clotting time (ACT) of 300-350 seconds. Patients who had procedures performed on continuous DOAC were compared to those on continuous warfarin. Clinical, procedural data, and complications occurring up to 3 months were analyzed from a prospective registry with additional review of electronic health records. A total of 1,884 procedures were performed over 28 months: 761 (609 patients) on uninterrupted warfarin and 1,123 (900 patients) on uninterrupted DOAC (rivaroxaban 64%, apixaban 32%, and dabigatran 4%). There was no difference in the composite endpoint of death, thromboembolism, or major bleeding complication (2.2% vs 1.4%, P = 0.20). There was no difference in the complications comprising this, including tamponade, hem...Continue Reading

Associated Clinical Trials

References

Apr 22, 2005·Journal of Thrombosis and Haemostasis : JTH·S SchulmanUNKNOWN Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on T
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Dec 10, 2009·Circulation. Arrhythmia and Electrophysiology·Riccardo CappatoElia Biganzoli
Nov 9, 2010·Current Cardiology Reports·Juan F Viles-Gonzalez, Davendra Mehta
Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
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
Jul 13, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Kenichi KasenoHiroshi Tada
Aug 8, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·David SnipeliskyFred Kusumoto
Oct 16, 2012·Journal of the American College of Cardiology·Roland Richard TilzFeifan Ouyang
Apr 5, 2013·Circulation. Arrhythmia and Electrophysiology·Mohamed BassiounyOussama Wazni
Feb 20, 2014·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·Rui ProvidênciaSerge Boveda
May 16, 2015·European Heart Journal·Riccardo CappatoUNKNOWN VENTURE-AF Investigators
Jul 29, 2015·Journal of Cardiovascular Electrophysiology·Andreas RilligFeifan Ouyang
Sep 2, 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·Hein HeidbuchelPaulus Kirchhof
Oct 16, 2015·Journal of Cardiovascular Electrophysiology·Andreas RilligRoland Richard Tilz
Mar 21, 2017·The New England Journal of Medicine·Hugh CalkinsUNKNOWN RE-CIRCUIT Investigators

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Citations

Jul 9, 2020·Journal of Cardiovascular Electrophysiology·Antonio CretaRui Providência
Feb 21, 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·Lisa W M Leung, Mark M Gallagher
Dec 17, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Huang SongqunCao Jiang

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