We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Minimally interrupted novel oral anticoagulant versus uninterrupted vitamin K antagonist during atrial fibrillation ablation.
- Authors
De Heide, John; Vroegh, Christiaan J.; Bhagwandien, Rohit E.; Wijchers, Sip A.; Szili-Torok, Tamas; Zijlstra, Felix; Lenzen, Mattie J.; Yap, S. C.
- Abstract
<bold>Purpose: </bold>The safety and efficacy of a minimally interrupted novel oral anticoagulant (NOAC) strategy at the time of atrial fibrillation (AF) ablation is uncertain. The purpose of this study was to compare rates of bleeding and thromboembolic events between minimally interrupted NOAC and uninterrupted vitamin K antagonist (VKA) in patients undergoing AF ablation.<bold>Methods: </bold>This was a retrospective single-center cohort study of consecutive patients who underwent AF catheter ablation between January 2013 and April 2017. Endpoints included major bleeding, clinically relevant non-major bleeding and systemic thromboembolic event from the time of ablation through 30 days. Bleeding events were defined by the Bleeding Academic Research Consortium (BARC) and International Society on Thrombosis and Haemostasis (ISTH).<bold>Results: </bold>A total of 637 patients were included in the analysis, 520 patients used uninterrupted VKA and 117 patients minimally interrupted NOAC (dabigatran: n = 68; apixaban: n = 30; rivaroxaban, n = 14; edoxaban, n = 5). The rate of clinically relevant non-major bleeding was lower in the NOAC group in comparison to the VKA group (BARC type 2: 2.6% versus 8.3%, P = 0.03; ISTH: 0% versus 3.8%, P = 0.03). Rates of major bleeding were similar between groups (BARC type 3 to 5: 3.4% versus 4.2%, P = NS; ISTH: 6.0% versus 8.7%, P = NS; for NOAC and VKA groups, respectively). Rates of systemic embolism were 0% with minimally interrupted NOAC, and 0.6% with uninterrupted VKA (P = NS).<bold>Conclusions: </bold>In patients undergoing AF ablation, anticoagulation with minimally interrupted NOAC was associated with fewer clinically relevant non-major bleeding events in comparison with uninterrupted VKA without compromising thromboembolic safety.
- Subjects
NETHERLANDS; ATRIAL fibrillation treatment; CATHETER ablation; ANTICOAGULANTS; VITAMIN K; COHORT analysis; THROMBOEMBOLISM; HEMORRHAGE diagnosis; PREVENTION of surgical complications; THROMBOEMBOLISM prevention; ATRIAL fibrillation; HEMORRHAGE; LONGITUDINAL method; EVALUATION of medical care; SURGICAL complications; RETROSPECTIVE studies; CHEMICAL inhibitors
- Publication
Journal of Interventional Cardiac Electrophysiology, 2018, Vol 53, Issue 3, p341
- ISSN
1383-875X
- Publication type
journal article
- DOI
10.1007/s10840-018-0417-0