Ablation of Atrial Fibrillation Without Left Atrial Appendage Imaging in Patients Treated With Direct Oral Anticoagulants
Key result
AF ablation without TEE or ICE in DOAC-compliant patients carries a 0.3% thromboembolic complication rate.
- n=900
Why the study?
Many centers routinely perform TEE before AF ablation in DOAC-treated patients, and safety of omitting TEE screening or ICE appendage imaging remained unproven.
Does atrial fibrillation ablation without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage result in low thromboembolic complications in DOAC-compliant patients?
Population
Consecutive patients presenting with AF or atrial flutter on DOAC undergoing ablation
Comparison
Ablation without transesophageal echocardiogram screening or intracardiac echocardiography appendage imaging
Design
Registry-based cohort study
Authors
Discussion
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Member takes
Implication
Supports omitting routine TEE/ICE in DOAC-compliant AF ablation; leaves open need for randomized confirmation.
Study Design
Type
Cohort (n=900)
Multicenter
No
Structured PICO
Does atrial fibrillation ablation without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage result in low thromboembolic complications in DOAC-compliant patients?
P
Population
900 consecutive patients presenting with atrial fibrillation or atrial flutter on DOAC therapy undergoing ablation at the Cleveland Clinic (2011-2018).
I
Intervention
Atrial fibrillation ablation without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the left atrial appendage
O
Outcome
Periprocedural thromboembolic complicationssafety
In DOAC-compliant patients undergoing AF ablation, omitting routine TEE or ICE imaging of the left atrial appendage is associated with a very low risk of periprocedural thromboembolic complications.
Cite This Study
Diab et al. (2020) conducted a cohort in Atrial fibrillation or atrial flutter (n=900). Ablation without transesophageal echocardiogram or intracardiac echocardiography imaging was evaluated on Periprocedural thromboembolic complications. Atrial fibrillation ablation without transesophageal echocardiogram or intracardiac echocardiography imaging in DOAC-compliant patients resulted in a low rate of thromboembolic complications (0.3%).