Evidence map›Paper›PMID 30074120›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2018

Minimally interrupted novel oral anticoagulant versus uninterrupted vitamin K antagonist during atrial fibrillation ablation.

John De Heide, Christiaan J Vroegh, Rohit E Bhagwandien, Sip A Wijchers, Tamas Szili-Torok, Felix Zijlstra, Mattie J Lenzen, S C Yap

Open access · hybridAbstract read
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

John De HeideDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Christiaan J VroeghDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Rohit E BhagwandienDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Sip A WijchersDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Tamas Szili-TorokDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Felix ZijlstraDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
Mattie J LenzenDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
S C YapDepartment of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands. s.c.yap@erasmusmc.nl.ORCID http://orcid.org/0000-0003-4520-2725
Erasmus MC · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe 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.

methodsThis 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).

resultsA 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).

conclusionsIn 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.

Indexed as

AnticoagulantsAtrial FibrillationHemorrhagePostoperative ComplicationsThromboembolismAgedCatheter AblationCohort StudiesFactor Xa InhibitorsFemaleHumansMaleMiddle AgedNetherlandsOutcome and Process Assessment, Health CareRetrospective StudiesAnticoagulantsFactor Xa InhibitorsVitamin KAtrial fibrillationBleedingCatheter ablationNovel oral anticoagulationStrokeVitamin-K antagonist

Identifiers

PMID30074120
PMCPMC6292967
OpenAlexW2886601757

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.