SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2013
Dabigatran for periprocedural anticoagulation following radiofrequency ablation for atrial fibrillation: a meta-analysis of observational studies.
Synthesis 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 19 papers, 2 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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- 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
- Risk-Benefit Profile of Direct-Acting Oral Anticoagulants in Established Therapeutic Indications: An Overview of Systematic Reviews and Observational Studies.Drug safety · 2016Review
- 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
- Almanac 2015: atrial fibrillation research in Heart.Heart (British Cardiac Society) · 2016Review
- 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
- Peri-procedural interrupted oral anticoagulation for atrial fibrillation ablation: comparison of aspirin, warfarin, dabigatran, and rivaroxaban.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 · 2014Article
- Comparative safety of periablation anticoagulation strategies for atrial fibrillation: data from a large multicenter study.Pacing and clinical electrophysiology : PACE · 2014Observational
- 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
- 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 Safetyof Dabigatran Versus Warfarin in Patients Undergoing Atrial Fibrillation Ablation.Journal of atrial fibrillationArticle
- Post-Procedural Dabigatran Versus Interrupted Warfarin Therapy Following Catheter Ablation for Atrial Fibrillation.Journal of atrial fibrillationArticle
- The Rate Of Complications Associated With Concomitant Use Of Dabigatran With Cryoballoon Ablation For Atrial Fibrillation.Journal of atrial fibrillationArticle
- My Patient Taking A Novel Oral Anticoagulant Needs Surgery, Device Implantation, Or Ablation.Journal of atrial fibrillationReview
- Safety And Efficacy Of Uninterrupted Periprocedural Apixaban In Patients Undergoing Atrial Fibrillation Catheter Ablation: A Metaanalysis Of 1,057 Patients.Journal of atrial fibrillationReview
- Comparison of peri-procedural anticoagulation with rivaroxaban and apixaban during radiofrequency ablation of atrial fibrillation.Indian pacing and electrophysiology journalArticle
- Are Some Anticoagulants More Equal Than Others? - Evaluating the Role of Novel Oral Anticoagulants in AF Ablation.Current cardiology reviewsReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
purposeDabigatran is approved for prevention of stroke or systemic embolism in patients with nonvalvular atrial fibrillation (AF). The safety and effectiveness of periprocedural dabigatran in ablation for AF are unknown.
methodsWe performed a meta-analysis of all studies comparing periprocedural dabigatran with warfarin for anticoagulation in AF ablation. Studies of >100 patients with post-procedure follow-up were included. Outcomes were compared by calculating maximum likelihood estimates with confidence intervals. The co-primary endpoints were neurological events and major bleeding.
resultsTen cohort studies were included, including a total of 1,501 patients receiving dabigatran and 2,356 receiving warfarin. The mean age was 59-64 years and inclusion of women varied (10-33 %). Intra-procedural unfractionated heparin and irrigated ablation catheters were used routinely. Adverse events were low overall; however, the dabigatran group demonstrated a numerical excess of neurological events (10/1,501 [0.7 %] versus 4/2,356 [0.2 %]), but equivalent major bleeding outcomes (24/1,501 [1.6 %] versus 40/2,356 [1.7 %]). In the meta-analysis, there was a nonsignificant trend towards higher rates of the composite primary endpoints (any neurological event or major bleeding) in the dabigatran group. Dabigatran demonstrated a significantly higher rate of neurological events (estimated absolute risk difference 0.0047, 95 % confidence interval 0.0007 to 0.0099).
conclusionsCompared with warfarin, dabigatran may be associated with a higher frequency of periprocedural neurological events following radiofrequency ablation of AF. Randomized clinical trials are needed to definitively assess the safety and efficacy of novel oral anticoagulant use for periprocedural anticoagulation for ablation of AF.
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What 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.