Radiofrequency ablation of atrial fibrillation under therapeutic international normalized ratio: A safe and efficacious periprocedural anticoagulation strategy

Hussein, Ayman A.; Martin, David O.; Saliba, Walid; Patel, Deven; Karim, Saima; Batal, Omar; Banna, Mustafa; Williams-Andrews, Michelle; Sherman, Minerva; Kanj, Mohamed; Bhargava, Mandeep; Dresing, Thomas; Callahan, Thomas; Tchou, Patrick; Biase, Luigi Di; Beheiry, Salwa; Lindsay, Bruce D.; Wazni, Oussama

doi:10.1016/j.hrthm.2009.07.007

Cited by 148 publications

(105 citation statements)

References 10 publications

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“…[1][2][3] Several studies have shown that the periprocedural continuation of therapeutic warfarin could reduce thromboembolic complications without increasing the risk of hemorrhagic complications. [4][5][6][7][8][9] In addition, it has been reported that cardiac tamponade as a complication of AF ablation is not difficult to manage when the procedure is performed under therapeutic international normalized ratio (INR). 9 …”

mentioning

confidence: 99%

Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Kaseno

Naito

Nakamura

et al. 2012

Circ J

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mentioning

confidence: 99%

Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Kaseno

Naito

Nakamura

et al. 2012

Circ J

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“…Later, Hussein et al 19 have published a study with a significant number of patients with paroxysmal and persistent AF, in which the strategy of maintaining warfarin during ablation was also adopted. The study comprised 3,052 patients referred for ablation for AF with INR > 1.8 on the day of the intervention (mean INR, 2.53 ± 0.62).…”

Section: Previously Published Studiesmentioning

confidence: 99%

“…To prevent possible complications related to that regimen, the strategy of performing the procedure without withholding warfarin (with therapeutic INR and no LMWH) has been proposed in centers of excellence 18,19 . This strategy represents a paradigm shift, because invasive procedures in patients undergoing oral anticoagulation (OAC) are classically believed to carry a high risk of hemorrhagic complications.…”

Section: Introductionmentioning

confidence: 99%

Segurança da ablação de fibrilação atrial com RNI terapêutico: comparação com a transição com heparina de baixo peso

Saad¹,

Costa²,

Costa³

et al. 2011

Arq. Bras. Cardiol.

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“…However, stroke and thromboembolism can be serious periprocedural complications following left atrial ablation (3). AF ablation utilizing uninterrupted dose-adjusted warfarin has been shown to be safe and it is associated with fewer major bleeding complications (4,5) than an approach using low molecular-weight heparin while bridging with discontinuous warfarin (6). Because in interrupted anticoagulation therapy for AF ablation, heparin is used as an anticoagulant during the periprocedural period, in particular, against an activated coagulation cascade (7), we have to simultaneously be on the lookout for both thromboembolic complications and bleeding complications.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Safety of Uninterrupted Dabigatran Therapy in Patients Undergoing Ablation for Atrial Fibrillation

et al. 2015

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Objective Uninterrupted oral warfarin strategy has become the standard protocol to prevent complications during catheter ablation (CA) for the treatment of atrial fibrillation (AF). However, little is known about the safety and efficacy of uninterrupted dabigatran therapy in patients undergoing CA for AF. Therefore, this study investigated the safety and efficacy of uninterrupted dabigatran therapy and compared the findings with those for uninterrupted warfarin therapy. Methods Bleeding and thromboembolic events during the periprocedural period were evaluated in 363 consecutive patients who underwent CA for AF at Nagoya University Hospital, and received uninterrupted dabigatran (n=173) or uninterrupted warfarin (n=190) for periprocedural anticoagulation. Results A total of 27 (7%) patients experienced either bleeding or thromboembolic complications. Major bleeding complications occurred in 2 (1%) patients in the dabigatran group (DG) and 2 (1%) patients in the warfarin group (WG). Eight (5%) patients in the DG and 9 (5%) patients in the WG experienced groin hematoma, a type of minor bleeding complication. Meanwhile, no patient in the DG and 1 (1%) in the WG developed cerebral ischemic stroke. Overall, there was no significant difference between the groups for any category. The activated partial thromboplastin time (APTT) independently predicted periprocedural complications in the DG. Conclusion Uninterrupted dabigatran therapy in CA for AF thus may be a safe and effective anticoagulant therapy, and appears to be closely similar to continuous warfarin; however, it is essential to pay close attention to the APTT values when using dabigatran during CA.

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Radiofrequency ablation of atrial fibrillation under therapeutic international normalized ratio: A safe and efficacious periprocedural anticoagulation strategy

Cited by 148 publications

References 10 publications

Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Segurança da ablação de fibrilação atrial com RNI terapêutico: comparação com a transição com heparina de baixo peso

Feasibility and Safety of Uninterrupted Dabigatran Therapy in Patients Undergoing Ablation for Atrial Fibrillation

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