Use of dabigatran for periprocedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation

Mohamed Bassiouny, Walid Saliba, John Rickard, Mingyuan Shao, Albert Sey, Mariam Diab, David O. Martin, Ayman Hussein, Maurice Khoury, Bernard Abi-Saleh, Samir Alam, Jay Sengupta, P. Peter Borek, Bryan Baranowski, Mark Niebauer, Thomas Callahan, Niraj Varma, Mina Chung, Patrick J. Tchou, Mohamed KanjThomas Dresing, Bruce D. Lindsay, Oussama Wazni

Research output: Contribution to journalArticlepeer-review

Abstract

Background-Pulmonary vein isolation (PVI) for atrial fibrillation is associated with a transient increased risk of thromboembolic and hemorrhagic events. We hypothesized that dabigatran can be safely used as an alternative to continuous warfarin for the periprocedural anticoagulation in PVI. Methods and Results-A total of 999 consecutive patients undergoing PVI were included; 376 patients were on dabigatran (150 mg), and 623 patients were on warfarin with therapeutic international normalization ration. Dabigatran was held 1 to 2 doses before PVI and restarted at the conclusion of the procedure or as soon as patients were transferred to the nursing floor. Propensity score matching was applied to generate a cohort of 344 patients in each group with balanced baseline data. Total hemorrhagic and thromboembolic complications were similar in both groups, before (3.2% versus 3.9%; P=0.59) and after (3.2% versus 4.1%; P=0.53) matching. Major hemorrhage occurred in 1.1% versus 1.6% (P=0.48) before and 1.2% versus 1.5% (P=0.74) after matching in the dabigatran versus warfarin group, respectively. A single thromboembolic event occurred in each of the dabigatran and warfarin groups. Despite higher doses of intraprocedural heparin, the mean activated clotting time was significantly lower in patients who held dabigatran for 1 or 2 doses than those on warfarin. Conclusions-Our study found no evidence to suggest a higher risk of thromboembolic or hemorrhagic complications with use of dabigatran for periprocedural anticoagulation in patients undergoing PVI compared with uninterrupted warfarin therapy.

Original languageEnglish (US)
Pages (from-to)460-464
Number of pages5
JournalCirculation: Arrhythmia and Electrophysiology
Volume6
Issue number3
DOIs
StatePublished - Jun 2013

Keywords

  • Ablation
  • Anticoagulants
  • Catheter ablation
  • Fibrillation
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Use of dabigatran for periprocedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation'. Together they form a unique fingerprint.

Cite this