Safety of atrial fibrillation ablation with novel multi-electrode array catheters on uninterrupted anticoagulation-a single-center experience.
AffiliationCardiac Arrhythmia Service, St Vincent's University Hospital, Elm Park, Dublin,, Ireland. email@example.com
Anticoagulants/administration & dosage
Catheter Ablation/*adverse effects
Postoperative Hemorrhage/*etiology/*prevention & control
Warfarin/*administration & dosage
MetadataShow full item record
CitationJ Interv Card Electrophysiol. 2010 Mar;27(2):117-22.
JournalJournal of interventional cardiac electrophysiology : an international journal of, arrhythmias and pacing
AbstractINTRODUCTION: A recent single-center report indicated that the performance of atrial fibrillation ablation in patients on uninterrupted warfarin using a conventional deflectable tip electrode ablation catheter may be as safe as periprocedural discontinuation of warfarin and bridging with heparin. Novel multi-electrode array catheters for atrial fibrillation ablation are currently undergoing clinical evaluation. While offering the possibility of more rapid atrial fibrillation ablation, they are stiffer and necessitate the deployment of larger deflectable transseptal sheaths, and it remains to be determined if they increase the risk of cardiac perforation and vascular injury. Such potential risks would have implications for a strategy of uninterrupted periprocedural anticoagulation. METHOD AND RESULTS: We audited the safety outcomes of our atrial fibrillation ablation procedures using multi-electrode array ablation catheters in patients on uninterrupted warfarin (CHADS2 score>or=2) and in patients not on warfarin (uninterrupted aspirin). Two bleeding complications occurred in 49 patients on uninterrupted warfarin, both of which were managed successfully without longterm sequelae, and no bleeding complication occurred in 32 patients not on warfarin (uninterrupted aspirin). There were no thromboembolic events or other complication with either anticoagulant regimen. CONCLUSION: Despite the larger diameter and increased stiffness of multi-electrode array catheters and their deflectable transseptal sheaths, their use for catheter ablation in patients with atrial fibrillation on uninterrupted warfarin in this single-center experience does not appear to be unsafe, and thus, an adequately powered multicenter prospective randomized controlled trial should be considered.
- Feasibility and safety of uninterrupted periprocedural apixaban administration in patients undergoing radiofrequency catheter ablation for atrial fibrillation: Results from a multicenter study.
- Authors: Di Biase L, Lakkireddy D, Trivedi C, Deneke T, Martinek M, Mohanty S, Mohanty P, Prakash S, Bai R, Reddy M, Gianni C, Horton R, Bailey S, Sigmund E, Derndorfer M, Schade A, Mueller P, Szoelloes A, Sanchez J, Al-Ahmad A, Hranitzky P, Gallinghouse GJ, Hongo RH, Beheiry S, Pürerfellner H, Burkhardt JD, Natale A
- Issue date: 2015 Jun
- Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation.
- Authors: Calkins H, Willems S, Gerstenfeld EP, Verma A, Schilling R, Hohnloser SH, Okumura K, Serota H, Nordaby M, Guiver K, Biss B, Brouwer MA, Grimaldi M, RE-CIRCUIT Investigators.
- Issue date: 2017 Apr 27
- Efficacy and safety of uninterrupted rivaroxaban taken preoperatively for radiofrequency catheter ablation of atrial fibrillation compared to uninterrupted warfarin.
- Authors: Tao S, Otomo K, Ono Y, Osaka Y, Hirao T, Koura K, Manno T, Ueshima D, Shimizu S, Isobe M, Hirao K
- Issue date: 2017 Mar
- Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance?
- Authors: Page SP, Siddiqui MS, Finlay M, Hunter RJ, Abrams DJ, Dhinoja M, Earley MJ, Sporton SC, Schilling RJ
- Issue date: 2011 Mar
- Continuous warfarin versus periprocedural dabigatran to reduce stroke and systemic embolism in patients undergoing catheter ablation for atrial fibrillation or left atrial flutter.
- Authors: Kaiser DW, Streur MM, Nagarakanti R, Whalen SP, Ellis CR
- Issue date: 2013 Sep