Meta-Analysis of Efficacy and Safety of Rivaroxaban Compared With Warfarin or Dabigatran in Patients Undergoing Catheter Ablation for Atrial Fibrillation

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Leki z grupy NOAC są alternatywą dla warfaryny [478,[761][762][763][764][765]. W obserwacyjnych kohortach pacjentów poddawanych ablacji przezcewnikowej w doświadczonych ośrodkach, u których stosowano nieprzerwane leczenie za pomocą NOAC, nie uzyskano danych wskazujących na niekorzystny wpływ takiego postępowania na bezpieczeństwo leczenia [761,763,766,767]. Wyniki pierwszej kontrolowanej próby klinicznej, w której porównywano nieprzerwane leczenie za pomocą NOAC i VKA u pacjentów poddawanych ablacji AF, do której włączono ok. 200 osób, niedawno opublikowano [768], podobnie jak kilka doniesień z obserwacyjnych baz danych [761,769,770].…”

Meta-analysis of risk of stroke and thrombo-embolism with rivaroxaban versus vitamin K antagonists in ablation and cardioversion of atrial fibrillation

“…A recent meta-analysis, included fewer number of studies and patients, compared rivaroxaban to warfarin in ablation procedures and showed equal safety and efficacy of both strategies [3]. While size of this meta-analysis makes it the largest report on this comparison and the findings of lower stroke and thrombo-embolic events during ablation and cardioversion procedures with use of rivaroxaban compared to VKA is first to report.…”

“…There is no consensus about the optimal peri-procedural anticoagulation strategy and the use of new oral anticoagulants in cardioversion and ablation procedures is still being studied. Recent reports have suggested that rivaroxaban use during ablation and cardioversion may be safe and comparable to warfarin [3][4][5]. While one meta-analysis showed equal thromboembolic and bleeding events with the use of dabigatran compared with warfarin in ablation of atrial fibrillation [6], another meta-analysis with more studies suggested that dabigatran may be associated with increased risk of stroke/TIA compared to warfarin in ablation of atrial fibrillation [7].…”

Direct oral anticoagulants: unique properties and practical approaches to management

“…Many VKA-anticoagulated patients undergo cardiac ablation with uninterrupted anticoagulation therapy. A meta-analysis comparing bleeding and thromboembolism rates in warfarin and rivaroxaban patients showed similar rates in both efficacy and safety 33. The VENTURE-AF trial randomised patients undergoing cardiac ablation to receive uninterrupted rivaroxaban or VKA therapy 34.…”