ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2012
A comparison of bleeding complications post-ablation between warfarin and dabigatran.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- New oral anticoagulants compared to warfarin for perioperative anticoagulation in patients undergoing atrial fibrillation catheter ablation: a meta-analysis of continuous or interrupted new oral anticoagulants during ablation compared to interrupted or continuous warfarin.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2017Pooled it
- Bleeding risks with novel oral anticoagulants during catheter ablation of atrial fibrillation: a systematic review and network meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2015Pooled it
- Pooled it
- Safety and efficacy of dabigatran versus warfarin in patients undergoing catheter ablation of atrial fibrillation: a systematic review and meta-analysis.Heart (British Cardiac Society) · 2014Pooled it
- Dabigatran for periprocedural anticoagulation following radiofrequency ablation for atrial fibrillation: a meta-analysis of observational studies.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2013Pooled it
- A randomized comparison of two direct oral anticoagulants for patients undergoing cardiac ablation with a contemporary warfarin control arm.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Trial
- Comparison of phenprocoumon with direct oral anticoagulants in catheter ablation of atrial fibrillation.European heart journal open · 2023Article
- Silent cerebral lesions following catheter ablation for atrial fibrillation: a state-of-the-art review.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 · 2023Review
- Periprocedural Anticoagulation Management for Atrial Fibrillation Ablation: Current Knowledge and Future Directions.Current treatment options in cardiovascular medicine · 2018Review
- Safety and efficacy of DOACs vs acenocoumarol in patients undergoing catheter ablation of atrial fibrillation.Clinical cardiology · 2017Article
- The anticoagulant effect of heparin during radiofrequency ablation (RFA) in patients taking apixaban or rivaroxaban.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2017Observational
- Network meta-analysis of efficacy and safety of competitive oral anticoagulants in patients undergoing radiofrequency catheter ablation of atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2016Article
- Efficacy and Safety of Novel Oral Anticoagulants for Atrial Fibrillation Ablation: An Updated Meta-Analysis.Cardiology and therapy · 2016Article
- Review
- Practical issues in the management of novel oral anticoagulants-cardioversion and ablation.Journal of thoracic disease · 2015Review
- A comparison of bleeding complications between warfarin, dabigatran, and rivaroxaban in patients undergoing cryoballoon ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2014Article
- Safety of new oral anticoagulants for patients undergoing atrial fibrillation ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2014Article
- Comparative safety of periablation anticoagulation strategies for atrial fibrillation: data from a large multicenter study.Pacing and clinical electrophysiology : PACE · 2014Observational
- Article
- Optimal strategies including use of newer anticoagulants for prevention of stroke and bleeding complications before, during, and after catheter ablation of atrial fibrillation and atrial flutter.Current treatment options in cardiovascular medicine · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough warfarin has traditionally been used for reducing risk of stroke in patients with atrial fibrillation, over the past year, the direct thrombin inhibitor dabigatran has become an accepted alternative. No study has conclusively investigated bleeding risks of patients treated with dabigatran immediately following radiofrequency catheter ablation (RFCA) procedures.
methodsWe evaluated 156 consecutive patients referred for RFCA of atrial arrhythmias: 31 patients were on dabigatran and 125 patients were on warfarin. The incidence of bleeding complications during the first 48 h and the first week following ablation were recorded and comparisons made using Fisher's exact test. Major complications were defined as hemorrhage requiring blood products or the need for vascular intervention. Minor complications were defined as prolonged bleeding from the catheter insertion site, hematoma formation, or development of ecchymosis. Our study also took into account the intraprocedure activated clotting time (ACT) levels in an effort to describe any differences between both patient groups.
resultsThere were no differences in age, gender, procedure type, or level of intraprocedural anticoagulation between the warfarin and dabigatran groups. No major bleeding complications were observed in either patient group at either 48 h or 1 week postprocedure. Six of the 31 dabigatran patients and 21 of the 125 warfarin patients had minor bleeding complications. There was no statistically significant difference between the incidence of minor bleeding complications between the two groups (p = 0.7384), although rebleeding was more commonly observed in patients on dabigatran. In regard to the intraprocedure ACT levels, there was more variability in the dabigatran patient group, and it was more difficult to achieve the goal ACT level, yet these results did not affect overall bleeding complications.
conclusionIn our cohort, bleeding-related complications 48 h and 1 week post-ablation were similar for warfarin and dabigatran. Dabigatran is associated with more intraprocedural variability in ACT than warfarin.
Indexed as
Identifiers
22869389What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.