Evidence map›Paper›PMID 31701593›Full record

Trial reportJournal of cardiovascular electrophysiology2019

Activated clotting time on the day of atrial fibrillation ablation for minimally interrupted and uninterrupted direct oral anticoagulation therapy: Sequential changes, differences among direct oral anticoagulants, and ablation safety outcomes.

Hirosuke Yamaji, Takashi Murakami, Kazuyoshi Hina, Shunich Higashiya, Hiroshi Kawamura, Masaaki Murakami, Shigeshi Kamikawa, Satoshi Hirohata, Shozo Kusachi

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of cardiovascular electrophysiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

8 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Meta-analysis of controlled studies on minimally interrupted vs. continuous use of non-vitamin K antagonist oral anticoagulants in catheter ablation for atrial fibrillation.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 · 2021
    Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Article
  7. Review
  8. Article
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

9 authors.

Hirosuke YamajiHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.ORCID 0000-0002-7758-154X
Takashi MurakamiHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.
Kazuyoshi HinaHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.
Shunich HigashiyaHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.
Hiroshi KawamuraHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.
Masaaki MurakamiHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.
Shigeshi KamikawaHeart Rhythm Center, Okayama Heart Clinic, Okayama, Japan.
Satoshi HirohataDepartment of Medical Technology, Graduate School of Health Sciences, Okayama University, Okayama, Japan.
Shozo KusachiDepartment of Medical Technology, Graduate School of Health Sciences, Okayama University, Okayama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundActivated clotting time (ACT)-guided heparinization is used during atrial fibrillation (AF) ablation. Differences in sensitivity to ACT assays have been identified among different direct oral anticoagulants (DOACs).

objectiveWe aimed to examine ACT just before ablation (pre-ACT) for different ablation start times (9:00, 11:00, 13:00, or 15:00) and ablation safety outcomes in minimally interrupted (min-Int) and uninterrupted (Unint) DOAC regimens and examine differences in pre-ACT values among four DOACs.

methodsConsecutive patients were randomized into the min-Int (n = 307) or Unint (n = 277) groups. DOACs examined were apixaban, dabigatran, edoxaban, and rivaroxaban.

resultsNo sequential changes in pre-ACT values were observed for each DOAC used and for all four DOACs combined in the min-Int and Unint groups. There was no meaningful difference in pre-ACT at each ablation start time between the groups. Clinically significant differences in overall pre-ACT were not obtained between the groups (138 ± 24 vs 142 ± 23 seconds). The pre-ACT (baseline) value for dabigatran was on average 29 seconds higher than that for the other three DOACs. The min-Int and Unint groups showed similar thromboembolic (0% vs 0%) and bleeding event rates (major, 1% vs 0%; all, 3.5% vs 2.5%).

conclusionThe pre-ACT did not show a sequential change in the min-Int and Unint groups. No notable differences in the time-dependent change in pre-ACT between the groups were observed. Variations in baseline ACT suggest the need for moderate adjustment of ACT for adequate modification of heparin dose for the other three DOACs. Both regimens provided similar acceptable AF ablation safety outcomes.

Indexed as

Catheter AblationDrug MonitoringWhole Blood Coagulation TimeAction PotentialsAgedAntithrombinsAtrial FibrillationBlood CoagulationDabigatranDrug Administration ScheduleFactor Xa InhibitorsFemaleHeart RateHumansJapanMaleAntithrombinsapixabanDabigatranedoxabanFactor Xa InhibitorsPyrazolesPyridinesPyridonesRivaroxabanThiazolesbleedingcomplicationDOACheparinpulmonary vein isolationsupraventricular tachyarrhythmiathromboembolism

Identifiers

PMID31701593
PMCPMC6916399

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Registered trials

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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.