Background: In patients undergoing
catheter ablation (CA) for
atrial fibrillation (AF), the use of uninterrupted direct oral
anticoagulants (DOACs) is the current protocol. This study evaluated
bleeding complications following the uninterrupted use of 4 DOACs in patients undergoing CA for AF without any change in the dosing regimen. Moreover, we assessed differences between once- and twice-daily DOAC dosing in patients undergoing CA for AF who continued on DOACs without any change in the dosing regimen. Methods and Results: This study was a retrospective single-center cohort study of consecutive patients. All patients continued DOACs without interruption or changes to the dosing schedule, even in the case of morning procedures. The primary endpoint was the incidence of major
bleeding events within the first 30 days after CA. In all, 710 consecutive patients were included in the study.
Bleeding complications were less frequent in the uninterrupted twice- than once-daily DOACs group. However, the incidence of
cardiac tamponade across all DOACs was low (0.98%; 7/710), suggesting that uninterrupted DOACs without changes to the dosing regimen may be an acceptable strategy. The rate of total
bleeding events, including minor
bleeding (12/710; 1.6%), was also satisfactory. Conclusions: Uninterrupted DOACs without any change in dosing regimen for patients undergoing CA for AF is acceptable.
Bleeding complications may be less frequent in patients receiving DOACs twice rather than once daily.