Dabigatran in the peri-procedural period for radiofrequency ablation of atrial fibrillation: efficacy, safety, and impact on duration of hospital stay.

Abstract

PURPOSE:

Dabigatran is effective for both the prevention of stroke and bleeding in patients with atrial fibrillation (AF). However, the safety and efficacy of the use of dabigatran in the peri-procedural period for radiofrequency catheter ablation (RFCA) of AF is unknown. Therefore, the purpose of this study was to evaluate the safety and efficacy of dabigatran in the peri-procedural period for RFCA of AF and the duration of hospital stay.

METHODS:

Consecutive patients (n = 227) who underwent RFCA for AF were prospectively analyzed. Peri-procedural anticoagulant therapy with dabigatran (n = 101, D group) was compared with warfarin and heparin bridging (n = 126, W group). Dabigatran was discontinued 12-24 h before and restarted 3 h after the procedure. Warfarin was stopped 3 days before the procedure and unfractionated heparin was administered.

RESULTS:

Ischemic stroke occurred in one patient of the D group (0.8 %). There was no significant difference between the two groups in the incidence of major bleeding (three cases of cardiac tamponade in each group and one case of intracranial bleeding in the W group, p = 0.93) or minor bleeding (five cases in the D group vs. five in the W group, p = 0.54). The duration of hospital stay was significantly shorter in the D group than in the W group (7.2 vs. 10.3 days, p = 0.0001).

CONCLUSIONS:

Peri-procedural anticoagulation therapy with dabigatran for RFCA of AF was equally safe and effective compared with warfarin and heparin bridging. The use of dabigatran for RFCA of AF shortened the duration of hospital stay.

• Authors: Kimitake Imamura, Akihiro Yoshida, Asumi Takei, Koji Fukuzawa, Kunihiko Kiuchi, Kaoru Takami, Mitsuru Takami, Mitsuaki Itoh, Ryudo Fujiwara, Atsushi Suzuki, Tomoyuki Nakanishi, Soichiro Yamashita, Akinori Matsumoto, Ken-Ichi Hirata
• Journal: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (J Interv Card Electrophysiol) Vol. 37 Issue 3 Pg. 223-31 (Sep 2013) ISSN: 1572-8595 [Electronic] Netherlands
• PMID: 23585240 (Publication Type: Journal Article, Observational Study, Research Support, N.I.H., Extramural)

Chemical References

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

Topics

• Anticoagulants (administration & dosage)
• Antithrombins (administration & dosage)
• Atrial Fibrillation (epidemiology, surgery)
• Benzimidazoles (administration & dosage)
• Catheter Ablation (statistics & numerical data)
• Comorbidity
• Dabigatran
• Decision Making
• Drug-Related Side Effects and Adverse Reactions (epidemiology)
• Evidence-Based Medicine
• Female
• Humans
• Japan (epidemiology)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Premedication (statistics & numerical data)
• Risk Factors
• Thromboembolism (epidemiology, prevention & control)
• Treatment Outcome
• beta-Alanine (administration & dosage, analogs & derivatives)