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- Title
Safety and Efficacy of Switching Anticoagulation to Aspirin Three Months after Successful Radiofrequency Catheter Ablation of Atrial Fibrillation.
- Authors
Jae-Sun Uhm; Hoyoun Won; Boyoung Joung; Gi-Byoung Nam; Kee-Joon Choi; Moon-Hyoung Lee; You-Ho Kim; Hui-Nam Pak
- Abstract
Purpose: Although current guidelines recommend continuing the same antithrombotic strategy regardless of rhythm control after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF), anticoagulation has a risk of major bleeding. We evaluated the safety of switching warfarin to aspirin in patients with successful AF ablation. Materials and Methods: Among 721 patients who underwent RFCA of AF, 608 patients (age, 57.3±10.9 years; 77.0% male, 75.5% paroxysmal AF) who had no evidence of AF recurrence at 3 months post-RFCA were included. We compared the thromboembolic and hemorrhagic events in patients for whom warfarin was switched to aspirin (ASA group; n=296) and patients who were kept on warfarin therapy (W group; n=312). Results: There were no significant differences in CHA2DS2-VA.Sc or HAS-BLED scores between the groups. In 30 patients in the ASA group and 37 patients in W group, AF recurred and warfarin was restarted or maintained during the 18.0±12.2 months of follow-up. There were no significant differences in thromboembolic (0.3% vs. 1.0%, p=0.342) and major bleeding incidences (0.7% vs. 0.6%, p=0.958) between ASA and W groups during the follow-up period. In the 259 patients with a CHA2DS2-VA.Sc score ≥2, there were no significant differences in thromboembolism (0.8% and 2.2%, p=0.380) or major bleeding incidences (0.8% and 1.4%, p=0.640) between ASA and W groups. Conclusion: Switching warfarin to aspirin 3 months after successful RFCA of AF could be as safe and efficacious as long-term anticoagulation even in patients with CHA2DS2-VASc score >2. However, strict rhythm monitoring cannot be overemphasized.
- Subjects
ANTICOAGULANTS; DRUG efficacy; MEDICATION safety; ASPIRIN; RADIO frequency; CATHETER ablation; ATRIAL fibrillation
- Publication
Yonsei Medical Journal, 2014, Vol 55, Issue 5, p1238
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2014.55.5.1238