A strategy of idarucizumab for pericardial tamponade during perioperative period of atrial fibrillation ablation
| Autor: | Su Xin, Dong Jianzeng, Du Xin, Wang Wei, Yu Ronghui, Bai Rong, Chen Li-zhu, Li Songnan, Sang Caihua, Guo Xue-yuan, Long De-yong, Zhao Xin, Ma Changsheng, Tang Ribo, Jiang Chen-xi, Liu Nian |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Catheter ablation Antibodies Monoclonal Humanized Antithrombins Dabigatran Atrial Fibrillation Medicine Humans Perioperative Period Aged Retrospective Studies business.industry Atrial fibrillation Idarucizumab General Medicine Perioperative Middle Aged medicine.disease Surgery Cardiac Tamponade Embolism Pericardiocentesis Catheter Ablation Female Tamponade Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Pacing and clinical electrophysiology : PACEREFERENCES. 44(11) |
| ISSN: | 1540-8159 |
| Popis: | Objective To investigate the optimal idarucizumab (dabigatran antagonist) usage strategy for patients with acute pericardial tamponade receiving uninterrupted dabigatran during catheter ablation for atrial fibrillation (AF). Methods Ten patients presenting acute pericardial tamponade while receiving uninterrupted dabigatran during catheter ablation for AF in Beijing Anzhen Hospital from January 2019 to July 2020 were enrolled and retrospectively analyzed. A "wait and see" strategy of idarucizumab was carried out for all patients; in brief, idarucizumab was applied following pericardiocentesis, comprehensive evaluation of bleeding and hemostasis RESULTS: There were 5 males, 5 paroxysmal AF, and the average age of the patients was 64.0 ± 9.8 years. Among the 10 patients, 4 were treated with dabigatran 110 mg, 6 were treated with dabigatran 150 mg, and 1 was simultaneously given clopidogrel. The average time from pericardial tamponade to the last dose of dabigatran was 8.2 ± 3.4 h. All patients underwent pericardiocentesis successfully, and the average drainage volume was 322.5 ml (220.0 ml ± 935.0 ml). For reversal anticoagulation, 6 patients received protamine, and 5 patients received idarucizumab. Of the 5 patients who were treated with idarucizumab, 4 presented exact hemostasis, except for 1 patient who underwent continuous drainage and finally received surgery repair. The average time to restart anticoagulation was 1.1 ± 0.3 days after the procedure, and no rebleeding, embolism or deaths were observed. Conclusion The "wait and see" strategy of idarucizumab for acute pericardial tamponade during the perioperative period of catheter ablation for AF may be safe and feasible. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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