Dabigatran use in the peri-procedural period for radiofrequency ablation of atrial fibrillation showed no significant difference in major bleeding compared to warfarin and heparin bridging (3.0% vs 3.2%, p=0.93), but significantly shortened hospital stay.
Cohort (n=227)
No
Does peri-procedural dabigatran improve safety, efficacy, and duration of hospital stay compared to warfarin and heparin bridging in patients undergoing radiofrequency catheter ablation for atrial fibrillation?
Peri-procedural dabigatran for RFCA of AF is as safe and effective as warfarin with heparin bridging, and significantly reduces the duration of hospital stay.
Absolute Event Rate: 3% vs 3.2%
p-value: p=0.93
PURPOSE: Dabigatran is effective for both the prevention of stroke and bleeding in patients with atrial fibrillation (AF). However, the safety and efficacy of the use of dabigatran in the peri-procedural period for radiofrequency catheter ablation (RFCA) of AF is unknown. Therefore, the purpose of this study was to evaluate the safety and efficacy of dabigatran in the peri-procedural period for RFCA of AF and the duration of hospital stay. METHODS: Consecutive patients (n = 227) who underwent RFCA for AF were prospectively analyzed. Peri-procedural anticoagulant therapy with dabigatran (n = 101, D group) was compared with warfarin and heparin bridging (n = 126, W group). Dabigatran was discontinued 12-24 h before and restarted 3 h after the procedure. Warfarin was stopped 3 days before the procedure and unfractionated heparin was administered. RESULTS: Ischemic stroke occurred in one patient of the D group (0.8 %). There was no significant difference between the two groups in the incidence of major bleeding (three cases of cardiac tamponade in each group and one case of intracranial bleeding in the W group, p = 0.93) or minor bleeding (five cases in the D group vs. five in the W group, p = 0.54). The duration of hospital stay was significantly shorter in the D group than in the W group (7.2 vs. 10.3 days, p = 0.0001). CONCLUSIONS: Peri-procedural anticoagulation therapy with dabigatran for RFCA of AF was equally safe and effective compared with warfarin and heparin bridging. The use of dabigatran for RFCA of AF shortened the duration of hospital stay.
Imamura et al. (Sat,) conducted a cohort in Atrial fibrillation (n=227). Dabigatran vs. Warfarin and heparin bridging was evaluated on Major bleeding complications (p=0.93). Dabigatran use in the peri-procedural period for radiofrequency ablation of atrial fibrillation showed no significant difference in major bleeding compared to warfarin and heparin bridging (3.0% vs 3.2%, p=0.93), but significantly shortened hospital stay.
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