Key result
Uninterrupted twice-daily DOACs were associated with fewer bleeding complications compared to once-daily DOACs in patients undergoing catheter ablation for atrial fibrillation.
Why the study?
Uninterrupted DOACs are the standard protocol during CA for AF, but evaluating bleeding complications across 4 DOACs without regimen changes, including differences between once- and twice-daily dosing, was needed.
Does uninterrupted once-daily DOAC therapy compared to twice-daily DOAC therapy increase bleeding complications in patients undergoing catheter ablation for atrial fibrillation?
Cohort (n=710)
No
Does uninterrupted once-daily DOAC therapy compared to twice-daily DOAC therapy increase bleeding complications in patients undergoing catheter ablation for atrial fibrillation?
Uninterrupted DOAC therapy without a change in dosing regimen is an acceptable strategy for patients undergoing catheter ablation for atrial fibrillation, though twice-daily dosing may be associated with fewer bleeding complications than once-daily dosing.
Answers are grounded in this paper and cite their sources.
Once-daily DOAC was associated with higher bleeding after AF ablation; leaves open optimal regimen in randomized trials.
Background:In patients undergoing catheter ablation (CA) for atrial fibrillation (AF), the use of uninterrupted direct oral anticoagulants (DOACs) is the current protocol. This study evaluated bleeding complications following the uninterrupted use of 4 DOACs in patients undergoing CA for AF without any change in the dosing regimen. Moreover, we assessed differences between once- and twice-daily DOAC dosing in patients undergoing CA for AF who continued on DOACs without any change in the dosing regimen.
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Oshima et al. (2021) conducted a cohort in Atrial fibrillation (n=710). Twice-daily direct oral anticoagulants (DOACs) vs. Once-daily direct oral anticoagulants (DOACs) was evaluated on Incidence of major bleeding events within the first 30 days after catheter ablation (p=0.016). Uninterrupted twice-daily DOACs were associated with fewer bleeding complications compared to once-daily DOACs in patients undergoing catheter ablation for atrial fibrillation.
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