Feasibility And Safety of uninterrupted peri-procedural Apixaban administration in patients undergoing radiofrequency catheter ablation for atrial fibrillation: Results From a Multicenter Study
| Autor: | Andrea Natale, Anja Schade, Salwa Beheiry, Shane Bailey, Patrick Mueller, Madhu Reddy, Luigi Di Biase, Chintan Trivedi, Rodney Horton, G. Joseph Gallinghouse, Amin Al-Ahmad, T. Deneke, Elisabeth Sigmund, Javier Sanchez, Helmut Pürerfellner, Prasant Mohanty, Martin Martinek, Richard Hongo, Carola Gianni, Dhanujaya Lakkireddy, Sameer Prakash, Rong Bai, Michael Derndorfer, Patrick Hranitzky, Sanghamitra Mohanty, Atilla Szoelloes, J. David Burkhardt |
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| Předmět: |
Male
medicine.medical_specialty Pyridones medicine.drug_class medicine.medical_treatment Activated clotting time Catheter ablation Postoperative Hemorrhage Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Prospective Studies Stroke Aged HAS-BLED medicine.diagnostic_test business.industry Anticoagulant Warfarin Anticoagulants Atrial fibrillation medicine.disease Surgery Diffusion Magnetic Resonance Imaging Catheter Ablation Cardiology Feasibility Studies Pyrazoles Female Apixaban Safety Cardiology and Cardiovascular Medicine business Factor Xa Inhibitors medicine.drug |
| Zdroj: | Europe PubMed Central |
| Popis: | Background Periprocedural anticoagulation management with uninterrupted warfarin and a "therapeutic" international normalized ratio is the best approach for reducing both thromboembolic and bleeding complications in the setting of catheter ablation for atrial fibrillation (AF). Objective The purpose of this study was to evaluate the safety and feasibility of uninterrupted apixaban in this setting. Methods This was a prospective multicenter registry of AF patients undergoing radiofrequency catheter ablation at 4 institutions in United States and Europe with uninterrupted apixaban. These patients were compared with an equal number of patients, matched for age, gender, and type of AF, undergoing AF ablation on uninterrupted warfarin. The apixaban group was comprised of consecutive patients who had taken their last dose of apixaban the morning of the procedure. A subset of 29 patients in the apixaban group underwent diffusion magnetic resonance imaging (dMRI) to detect silent cerebral ischemia. Results A total of 400 patients (200 patients in each group) were included in the study. The average age was 65.9 ± 9.9 years, 286 (71.5%) were male, and 334 (83.5%) had nonparoxysmal AF. There were no statistical differences with regard to major complications (1% vs 0.5%, P = 1), minor complications (3.5% vs 2.5%, P = .56), or total bleeding complications (4.5% vs 3%, P = .43) between the apixaban and warfarin groups. There were no symptomatic thromboembolic complications. All dMRIs were negative for "new" silent cerebral ischemia in the apixaban group. Conclusion Uninterrupted apixaban administration in patients undergoing AF ablation seems to be feasible and effective in preventing clinical and silent thromboembolic events without increasing the risk of major bleeding. |
| Databáze: | OpenAIRE |
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