ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2013
Continuous warfarin versus periprocedural dabigatran to reduce stroke and systemic embolism in patients undergoing catheter ablation for atrial fibrillation or left atrial flutter.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 6 of them syntheses that pooled it.
What it found
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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.
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Who cites it
20 citing papers in PubMed, 6 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias.The Cochrane database of systematic reviews · 2021Pooled it
- Novel oral anticoagulants in the preoperative period: a meta-analysis.Journal of thrombosis and thrombolysis · 2018Pooled it
- [S1 guideline - Austrian consensus for anticoagulation in the context of atrial fibrillation ablation].Wiener klinische Wochenschrift · 2018Guideline
- 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
- Uninterrupted Use of Oral Anticoagulants for the Ablation of Atrial Flutter: A Single Center Cohort of 154 Patients.Arquivos brasileiros de cardiologia · 2018Article
- 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
- Safety and efficacy of novel oral anticoagulants in the setting of atrial fibrillation ablation: Is it time to celebrate the "funeral" of warfarin?Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2014Article
- The role of novel anticoagulants in the management of venous thromboembolic disease.Current treatment options in cardiovascular medicine · 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
- Atrial Fibrillation and Stroke: Increasing Stroke Risk with Intervention.Cardiac electrophysiology clinics · 2014Review
- Atrial Fibrillation and Stroke - Increasing Stroke Risk With Intervention.Journal of atrial fibrillation · 2013Review
- Article
- Periprocedural dabigatran anticoagulation for atrial fibrillation ablation: do we have enough information to make a rational decision.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2013Article
- The clinical efficacy of dabigatran etexilate for preventing stroke in atrial fibrillation patients.Vascular health and risk management · 2013Review
- Are Some Anticoagulants More Equal Than Others? - Evaluating the Role of Novel Oral Anticoagulants in AF Ablation.Current cardiology reviewsReview
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLeft atrial catheter ablation for patients with atrial fibrillation (AF) requires periprocedural anticoagulation to minimize thromboembolic complications. High rates of major bleeding complications using dabigatran etexilate for periprocedural anticoagulation have been reported, raising concerns regarding its safety during left atrial catheter ablation. We sought to evaluate the safety and efficacy of a dabigatran use strategy versus warfarin, at a single high-volume AF ablation center.
methodsWe performed a retrospective analysis on consecutive patients undergoing left atrial ablation at Vanderbilt Medical Center from January 2011 through August 2012 with a minimum follow-up of 3 months. Patient cohorts were divided into two groups, those utilizing dabigatran etexilate pre- and post-ablation and those undergoing ablation on dose-adjusted warfarin, with or without low-molecular-weight heparin bridging. Dabigatran was held 24-30 h pre-procedure and restarted 4-6 h after hemostasis was achieved. We evaluated all thromboembolic and bleeding complications at 3 months post-ablation.
resultsA total of 254 patients underwent left atrial catheter ablation for atrial fibrillation or left atrial flutter. Periprocedural anticoagulation utilized dabigatran in 122 patients and warfarin in 135 patients. Three late thromboembolic complications occurred in the dabigatran group (2.5 %), compared with one (0.7 %) in the warfarin group (p = 0.28). The dabigatran group had similar minor bleeding (2.5 vs. 7.4 %, p = 0.07), major bleeding (1.6 vs. 0.7 %, p = 0.51), and composite of bleeding and thromboembolic complications (6.6 vs. 8.9 %, p = 0.49) when compared to warfarin. There were no acute thromboembolic complications in either group (<24 h post-ablation).
conclusionsIn patients undergoing left atrial catheter ablation for AF or left atrial flutter, use of periprocedural dabigatran etexilate provides a safe and effective anticoagulation strategy compared to warfarin. A prospective randomized study is warranted.
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