Dabigatran versus warfarin therapy for uninterrupted oral anticoagulation during atrial fibrillation ablation.

Abstract

BACKGROUND:

Uninterrupted oral anticoagulant (OA) therapy with warfarin has become the standard of care at many centers performing catheter ablation of atrial fibrillation (AF). Compared with warfarin, dabigatran, a direct thrombin inhibitor, has been demonstrated to reduce the risk of stroke in nonvalvular AF with similar bleeding risk. Few data exist on the safety profile of uninterrupted dabigatran therapy during AF ablation.

METHODS:

We compared the safety and efficacy of uninterrupted OA therapy with either warfarin or dabigatran in all patients undergoing AF catheter ablation at the University of Alabama at Birmingham between November 1, 2010 and January 31, 2012. All patients underwent a transesophageal echocardiogram (TEE) on the day of their ablation procedure to assess for the presence of intracardiac thrombi. All complications were identified and classified as bleeding, thromboembolic events, or other.

RESULTS:

There were 212 patients in the dabigatran group and 251 patients in the warfarin group. The groups were well matched. There were 3 complications in the dabigatran group and 6 in the warfarin group (P = 0.45). There were 2 bleeding complications in the dabigatran group and 6 in the warfarin group (P = 0.23). There was one thromboembolic complication (a possible TIA) in the dabigatran group and none in the warfarin group (P = 0.28).

CONCLUSION:

The administration of dabigatran is as safe and effective as warfarin for uninterrupted OA therapy during catheter ablation of AF.

• Authors: William Maddox, G Neal Kay, Takumi Yamada, Jose Osorio, Harish Doppalapudi, Vance J Plumb, Alicia Gunter, H Thomas McElderry
• Journal: Journal of cardiovascular electrophysiology (J Cardiovasc Electrophysiol) Vol. 24 Issue 8 Pg. 861-5 (Aug 2013) ISSN: 1540-8167 [Electronic] United States
• PMID: 23577951 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2013 Wiley Periodicals, Inc.

Chemical References

• Anticoagulants
• Antithrombins
• Benzimidazoles
• beta-Alanine
• Warfarin
• Dabigatran

Topics

• Administration, Oral
• Anticoagulants (administration & dosage, adverse effects)
• Antithrombins (administration & dosage, adverse effects)
• Atrial Fibrillation (diagnostic imaging, surgery)
• Benzimidazoles (administration & dosage, adverse effects)
• Catheter Ablation (methods)
• Dabigatran
• Echocardiography, Transesophageal
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Pulmonary Veins (diagnostic imaging, surgery)
• Warfarin (administration & dosage, adverse effects)
• beta-Alanine (administration & dosage, adverse effects, analogs & derivatives)