What question did this study set out to answer?

To evaluate real-world clinical practices and antithrombotic therapy routines for stroke prevention among patients undergoing atrial fibrillation ablation across European centers.

May 28, 2015EP EuropaceOpen Access

Oral anticoagulant therapy for stroke prevention in patients with atrial fibrillation undergoing ablation: results from the First European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA)

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To evaluate real-world clinical practices and antithrombotic therapy routines for stroke prevention among patients undergoing atrial fibrillation ablation across European centers.
Prospective, multicenter snapshot survey across 13 European countries enrolling consecutive patients undergoing atrial fibrillation ablation over a 6-week period in 2014 (N=455).
Assessed pre-ablation, periprocedural, and discharge oral anticoagulant regimens, stratifying risk using the CHA2DS2-VASc score and analyzing predictors via multivariate analysis.
Before ablation, 97.4% of patients (n=443/455) were on anticoagulants, with 58.0% (n=264) receiving vitamin K antagonists (VKAs) and 31.4% (n=143) receiving non-vitamin K antagonist oral anticoagulants (NOACs).
Ablation was performed without drug interruption in 79.7% of VKA-treated patients, whereas periprocedural interruption protocols varied widely among NOAC recipients.
At discharge, 89.3% continued their pre-procedure anticoagulant, with 62.2% (n=280) advised limited anticoagulation (mean 3.8 ± 2.2 months), which was significantly associated with CHA2DS2-VASc score, AF duration, prior VKA use, and estimated procedural success on multivariate analysis.

Structured PICO

Population

455 consecutive patients undergoing atrial fibrillation (AF) ablation across 13 countries, mean age 59 ± 10.8 years, 28.8% female.

Intervention

Periprocedural oral anticoagulant therapy (NOACs or VKAs)

Outcome

Clinical practice patterns regarding the use of antithrombotic therapies before, during, and after AF ablation

This European snapshot survey highlights the increasing use of NOACs in AF ablation and significant variability in periprocedural anticoagulation strategies, underscoring the need for standardized guidance.

Discussion

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Implication

Variability in post-AF ablation anticoagulation persists; leaves open optimal short-term strategies and standardized protocols.

Cite This Study

Potpara et al. (2015) studied this question.

synapsesocial.com/papers/6a7ed841e9bb045a73c3001c https://doi.org/10.1093/europace/euv132

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Oral anticoagulant therapy for stroke prevention in patients with atrial fibrillation undergoing ablation: results from the First European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA)

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Oral anticoagulant therapy for stroke prevention in patients with atrial fibrillation undergoing ablation: results from the First European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA)

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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