Key result
Uninterrupted direct oral anticoagulants during catheter ablation for atrial fibrillation resulted in similar rates of periprocedural complications compared to uninterrupted vitamin K antagonists (3.2% vs 4.8%, p=0.65).
Why the study?
Does uninterrupted DOAC therapy reduce periprocedural complications compared to uninterrupted VKA therapy in patients undergoing catheter ablation for atrial fibrillation?
Observational (n=376)
No
Does uninterrupted DOAC therapy reduce periprocedural complications compared to uninterrupted VKA therapy in patients undergoing catheter ablation for atrial fibrillation?
Uninterrupted DOAC therapy is a safe alternative to uninterrupted VKA therapy for patients undergoing catheter ablation of atrial fibrillation, with no significant difference in periprocedural ischemic or hemorrhagic complications.
Answers are grounded in this paper and cite their sources.
Comparable periprocedural safety supports uninterrupted DOAC as alternative to VKA in AF ablation; leaves open randomized confirmation.
BACKGROUND: Periprocedural anticoagulation is important in catheter ablation (CA) of atrial fibrillation (AF) and there is increasing evidence that uninterrupted vitamin K antagonist (VKA) therapy is superior to interrupted anticoagulation strategies. Since the emergence of direct oral anticoagulants (DOACs), numerous studies have shown promising results for their use in uninterrupted strategies. However, further studies are needed to further define the efficacy and safety of performing AF ablation with uninterrupted factor XA inhibitors or direct thrombin inhibitors. METHODS AND Therefore, we also analyzed the results using the propensity score-matching method. We found no significant difference in periprocedural complications between uninterrupted VKA or DOACs therapy (P=0.65). CONCLUSIONS: CA of AF without discontinuation of DOACs is not inferior to CA without discontinuation of a VKA, with regard to ischemic or hemorrhagic complications.
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Kojima et al. (2018) conducted an observational in Atrial Fibrillation (n=376). Uninterrupted direct oral anticoagulants (DOACs) vs. Uninterrupted vitamin K antagonist (VKA) was evaluated on Total periprocedural complications (propensity score-matched) (p=0.65). Uninterrupted direct oral anticoagulants during catheter ablation for atrial fibrillation resulted in similar rates of periprocedural complications compared to uninterrupted vitamin K antagonists (3.2% vs 4.8%, p=0.65).
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