ArticleArquivos brasileiros de cardiologia2020
Safety of Catheter Ablation of Atrial Fibrillation Under Uninterrupted Rivaroxaban Use.
Article in Arquivos brasileiros de cardiologia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- Atrial Fibrillation (Part 2) - Catheter Ablation.Arquivos brasileiros de cardiologia · 2021Article
- The legacy of Prof. Eduardo Sosa.Arquivos brasileiros de cardiologia · 2020Article
- Uninterrupted Direct Oral Anticoagulants in Atrial Fibrillation Catheter Ablation: Ready for Prime Time.Arquivos brasileiros de cardiologiaArticle
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) ablation under uninterrupted warfarin use is safe and recommended by experts. However, there is some controversy regarding direct-acting oral anticoagulants for the same purpose.
objectiveTo evaluate the safety of AF ablation under uninterrupted anticoagulation with rivaroxaban.
methodsA series of 130 patients underwent AF radiofrequency ablation under uninterrupted rivaroxaban use (RIV group) and was compared to a control group of 110 patients under uninterrupted warfarin use (WFR group) and therapeutic International Normalized Ratio (INR). We analyzed death, rates of thromboembolic events, major and minor bleedings, activated clotting time (ACT) levels, and heparin dose in the procedure. The ablation protocol basically consisted of circumferential isolation of the pulmonary veins guided by electroanatomic mapping. It was adopted a statistical significance of 5%.
resultsThe clinical characteristics of the groups were similar, and the paroxysmal AF was the most frequent type (63% and 59%, RIV and WFR groups). A thromboembolic event occurred in the RIV group. There were 3 patients with major bleeding (RIV = 1 and WFR = 2; p = 0.5); no deaths. Basal INR was higher in the WFR group (2.5 vs. 1.2 ± 0.02; p < 0.0001), with similar basal ACT levels (123.7 ± 3 vs. 118 ± 4; p= 0, 34). A higher dose of venous heparin was used in the RIV group (9,414 ± 199 vs. 6,019 ± 185 IU; p < 0.0001) to maintain similar mean ACT levels during the procedure (350 ± 3 vs. 348.9 ± 4; p = 0.79).
conclusionIn the study population, AF ablation under uninterrupted rivaroxaban showed a safety profile that was equivalent to uninterrupted warfarin use with therapeutic INR.
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