ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2014
Safety of new oral anticoagulants for patients undergoing atrial fibrillation ablation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 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
15 citing papers in PubMed, 6 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias.The Cochrane database of systematic reviews · 2021Pooled 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
- Efficacy and safety of rivaroxaban compared with vitamin K antagonists for peri-procedural anticoagulation in catheter ablation of atrial fibrillation: a systematic review and meta-analysis.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 · 2016Pooled 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
- Periprocedural Anticoagulation Management for Atrial Fibrillation Ablation: Current Knowledge and Future Directions.Current treatment options in cardiovascular medicine · 2018Review
- 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
- 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
- Management of the bleeding patient receiving new oral anticoagulants: a role for prothrombin complex concentrates.BioMed research international · 2014Review
- A clinician's perspective: novel oral anticoagulants to reduce the risk of stroke in nonvalvular atrial fibrillation--full speed ahead or proceed with caution?Vascular health and risk management · 2014Review
- My Patient Taking A Novel Oral Anticoagulant Needs Surgery, Device Implantation, Or Ablation.Journal of atrial fibrillationReview
- How To Follow Atrial Fibrillation Ablation Patients?Journal of atrial fibrillationReview
- The Nonvitamin K Antagonist Oral Anticoagulants and Atrial Fibrillation: Challenges and Considerations.Journal of atrial fibrillationReview
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe new oral anticoagulants (NOAC), dabigatran and rivaroxaban, have been demonstrated to be at least equivalent to warfarin for preventing cardiac thromboembolism (TE) in patients with atrial fibrillation (AF). However, there is limited data regarding use around catheter ablation (CA) procedures.
objectiveWe evaluated the risk of bleeding and TE complications associated with NOAC use during AF ablation.
methodsConsecutive patients undergoing AF ablation between January 2011 and 6 September 2013 were grouped based on peri-procedural anticoagulation regimen: (1) uninterrupted warfarin with therapeutic INR (WARF), n = 114, (2) dabigatran, n = 89, or (3) rivaroxaban, n = 98. NOACs were held for 24 h (dabigatran) or 36 h (rivaroxaban) prior to the procedure. Heparin infusion was initiated 6 h post-procedure for the NOAC groups; NOACs were resumed the morning after the procedure. Antral PVI was performed with activated clotting time (ACT) maintained >300 s. TE or bleeding complications during ablation and through 30 days were compared.
resultsThree hundred and one patients underwent ablation for paroxysmal (71%) or persistent (29%) AF. International Normalization Ratio (INR) for the WARF group was 2.0 ± 0.5. Baseline characteristics were similar among the groups. There were two TE events (asymptomatic cerebral emboli and TIA), and there were 17 bleeding events (large hematoma n = 4; pericardial effusion n = 6; persistent hematuria n = 1; pseudoaneurism/AV fistula n = 6). Of the six pericardial effusions, three required drainage. There was no significant difference in combined TE/bleeding risk among the groups (WARF vs. dabigatran vs. rivaroxaban; 6.2% vs. 6.7% vs. 6.0%; p = 0.82)
conclusionsIn this group of AF patients undergoing CA, use of peri-procedure dabigatran or rivaroxaban compared to uninterrupted warfarin did not lead to an increase in bleeding or TE complications.
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