Safety of Continuous Periprocedural Rivaroxaban for Patients Undergoing Left Atrial Catheter Ablation Procedures
| Autor: | Roger Dillier, Verena Semmler, Carsten Lennerz, Alessandra Buiatti, Gabriele Hessling, Isabel Deisenhofer, Monika Hofmann, Tilko Reents, Christof Kolb, Sonia Ammar, Herribert Pavaci, Bernhard M. Kaess, Susanne Kathan |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Time Factors Radiofrequency ablation medicine.medical_treatment law.invention Phenprocoumon Rivaroxaban Risk Factors law Germany Atrial Fibrillation Odds Ratio Registries medicine.diagnostic_test Atrial fibrillation Middle Aged Vitamin K antagonist Treatment Outcome Anesthesia Catheter Ablation Female Tamponade Cardiology and Cardiovascular Medicine medicine.drug medicine.medical_specialty medicine.drug_class Morpholines Activated clotting time Hemorrhage Catheter ablation Thiophenes Drug Administration Schedule Sex Factors Thromboembolism Physiology (medical) medicine Humans Heart Atria Aged Retrospective Studies Chi-Square Distribution business.industry Anticoagulants medicine.disease Surgery Logistic Models Multivariate Analysis business |
| Zdroj: | Circulation: Arrhythmia and Electrophysiology. 7:576-582 |
| ISSN: | 1941-3084 1941-3149 |
| DOI: | 10.1161/circep.114.001586 |
| Popis: | Background— This study aimed to evaluate the safety of continuous periprocedural rivaroxaban administration during left atrial radiofrequency ablation (RFA) in comparison with uninterrupted oral vitamin K antagonist administration. Data about the use of rivaroxaban in the setting of left atrial RFA procedures are lacking. Methods and Results— The study cohort included 544 patients (mean age, 63±10 years) who underwent left atrial RFA procedures between February 2012 and May 2013. All patients (n=272) receiving uninterrupted periprocedural rivaroxaban 15 or 20 mg/d before the procedure (rivaroxaban) were matched by age, sex, and type of rhythm disorder with an equal number of patients managed with uninterrupted vitamin K antagonist phenprocoumon (international normalized ratio, 2–3). During RFA, heparin was given intravenously to maintain an activated clotting time at 270 to 300 s. The safety end point was a composite of bleeding, thromboembolic events, and death. There were no thromboembolic complications and no deaths in either group. The prevalence of major bleeding complications was similar in both groups (1 tamponade in RivG and 1 groin hematoma requiring transfusion in phenprocoumon). Minor bleeding complications occurred equally in both groups (20 of 272; 7% in the rivaroxaban versus 33 of 272, 12% in the phenprocoumon; P =0.08). In multivariable analyses, female sex was associated with a greater risk of complications (odds ratio, 1.96; 95% confidence interval, 1.10–3.49). Conclusions— In patients undergoing left atrial RFA, continuous periprocedural rivaroxaban use seems to be as safe as uninterrupted periprocedural phenprocoumon administration. |
| Databáze: | OpenAIRE |
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