Periprocedural Stroke and Management of Major Bleeding Complications in Patients Undergoing Catheter Ablation of Atrial Fibrillation
Key result
Catheter ablation using an open irrigated catheter on warfarin resulted in 0% periprocedural stroke/TIA compared to off-warfarin strategies (1.1% and 0.9%), without increasing major bleeding.
Why the study?
Does catheter ablation with an open irrigated catheter on uninterrupted warfarin reduce periprocedural stroke compared to off-warfarin strategies in patients with atrial fibrillation?
Population
6454 consecutive patients undergoing catheter ablation of atrial fibrillation across 9 centers.
Comparison
Catheter ablation with an open irrigated… vs Catheter ablation with an 8-mm catheter off…
Design
Cohort
Follow-up
periprocedural (during and early after the procedures)
Authors
Discussion
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Member takes
Implication
May support uninterrupted warfarin with open irrigated catheters to minimize periprocedural stroke in AF ablation without excess bleeding; leaves open need for randomized confirmation.
Study Design
Type
Cohort (n=6,454)
Multicenter
Yes
Structured PICO
Does catheter ablation with an open irrigated catheter on uninterrupted warfarin reduce periprocedural stroke compared to off-warfarin strategies in patients with atrial fibrillation?
P
Population
6454 consecutive patients undergoing catheter ablation of atrial fibrillation across 9 centers.
I
Intervention
Catheter ablation with an open irrigated catheter on warfarin (group 3, n=2618)
C
Comparator
Catheter ablation with an 8-mm catheter off warfarin (group 1, n=2488) or an open irrigated catheter off warfarin (group 2, n=1348)
O
Outcome
Periprocedural stroke/transient ischemic attackhard clinical
Main Result
Absolute Event Rate: 0% vs 1.1%
Performing atrial fibrillation ablation with an open irrigated catheter and uninterrupted warfarin eliminates periprocedural stroke/TIA without increasing bleeding complications.
Cite This Study
Biase et al. (2010) conducted a cohort in Atrial fibrillation (n=6,454). Open irrigated catheter on warfarin vs. 8-mm catheter off warfarin and open irrigated catheter off warfarin was evaluated on Periprocedural stroke/transient ischemic attack. Catheter ablation using an open irrigated catheter on warfarin resulted in 0% periprocedural stroke/TIA compared to off-warfarin strategies (1.1% and 0.9%), without increasing major bleeding.