New Oral Anticoagulant Versus Vitamin K Antagonists for Thoracoscopic Ablation in Patients With Persistent Atrial Fibrillation: A Randomized Controlled Trial.

Abstract

Anticoagulation could not be currently stopped even after successful thoracoscopic ablation of atrial fibrillation for at least 2 months. The aim of this study is to compare the safety and efficacy outcomes between a new oral anticoagulant and warfarin after thoracoscopic ablation. This trial was a single-center, prospective, randomized controlled study comparing edoxaban and warfarin in patients undergoing thoracoscopic ablation of atrial fibrillation. This study enrolled 60 patients randomly assigned into 2 groups. The primary endpoint was efficacy outcomes, including stroke and systemic thromboembolic events. The secondary endpoint was safety outcomes including major bleeding and pericarditis. The patients were evaluated at discharge, 2 weeks, 3 months, and 6 months postoperatively. No stroke and thromboembolic events were noted in both treatment groups during the follow-up period. During the 6 months follow-up period, 4 (13%) of 30 patients in the edoxaban group experienced minor bleeding events, whereas none were noted in the warfarin group. Five anticoagulation-related events (bleeding, and prolongation of international normalized ratio), including pericarditis, were noted in both the edoxaban and warfarin groups. No statistically significant difference existed between the 2 groups. In conclusion, this study showed the comparable results of edoxaban to warfarin during the window period of post-thoracoscopic ablation of atrial fibrillation. Moreover, anticoagulation-related events were rather affected by patient factors and not by the anticoagulant type.

• Authors: Yoonseo Lee, Dong Seop Jeong, Joonghyun Ahn, Kyoung-Min Park, Seung-Jung Park, June Soo Kim, Young Keun On
• Journal: Seminars in thoracic and cardiovascular surgery (Semin Thorac Cardiovasc Surg) Vol. 35 Issue 2 Pg. 268-274 ( 2023) ISSN: 1532-9488 [Electronic] United States
• PMID: 34879226 (Publication Type: Randomized Controlled Trial, Journal Article)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Chemical References

• Warfarin
• edoxaban
• Anticoagulants
• Vitamin K

Topics

• Humans
• Warfarin (adverse effects)
• Atrial Fibrillation (diagnosis, drug therapy, surgery)
• Prospective Studies
• Treatment Outcome
• Anticoagulants (adverse effects)
• Stroke (etiology, prevention & control)
• Hemorrhage (chemically induced)
• Thromboembolism
• Pericarditis (complications)
• Vitamin K