Periprocedural Management of Direct Oral Anticoagulants Surrounding Cardioversion and Invasive Electrophysiological Procedures

Figures

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  FIGURE 1.. A, Anticoagulation during cardioversion for AF: ovals represent periods of anticoagulation; those that extend beyond the marked timeframes on the x axis indicate ongoing treatment. Where applicable, dosing timeframes are listed within individual ovals. B, Anticoagulation during cardiac ablation of AF (protocols with at least 1 interrupted treatment arm. Ovals represent periods of anticoagulation; those that extend beyond the marked timeframes on the x axis indicate ongoing treatment. Protocols with interrupted anticoagulation dosing are noted by dashed line boundaries. Where applicable, dosing interruption timeframes are listed within individual ovals. C, Anticoagulation during CIED procedures. Ovals represent periods of anticoagulation. Those that extend beyond the marked timeframes on the x axis indicate ongoing treatment. Protocols with interrupted anticoagulation dosing are noted by dashed line boundaries. Where applicable, dosing interruption timeframes are listed within individual ovals. AF indicates atrial fibrillation; CIED, cardiac implantable electric devices; TEE, transesophageal echocardiography.

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  FIGURE 2.. The intrinsic and extrinsic clotting pathways, including the sites of action (clotting inhibition by VKAs, heparins, and DOACs). Reproduced with permission from Clin Ther 2012;34:2051–2060.