Safety and Efficacy of Switching Anticoagulation to Aspirin Three Months after Successful Radiofrequency Catheter Ablation of Atrial Fibrillation
Yonsei Medical Journal
;
: 1238-1245, 2014.
Article
in English
| WPRIM
| ID: wpr-210338
ABSTRACT
PURPOSE:
Although current guidelines recommend continuing the same antithrombotic strategy regardless of rhythm control after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF), anticoagulation has a risk of major bleeding. We evaluated the safety of switching warfarin to aspirin in patients with successful AF ablation. MATERIALS ANDMETHODS:
Among 721 patients who underwent RFCA of AF, 608 patients (age, 57.3+/-10.9 years; 77.0% male, 75.5% paroxysmal AF) who had no evidence of AF recurrence at 3 months post-RFCA were included. We compared the thromboembolic and hemorrhagic events in patients for whom warfarin was switched to aspirin (ASA group; n=296) and patients who were kept on warfarin therapy (W group; n=312).RESULTS:
There were no significant differences in CHA2DS2-VASc or HAS-BLED scores between the groups. In 30 patients in the ASA group and 37 patients in W group, AF recurred and warfarin was restarted or maintained during the 18.0+/-12.2 months of follow-up. There were no significant differences in thromboembolic (0.3% vs. 1.0%, p=0.342) and major bleeding incidences (0.7% vs. 0.6%, p=0.958) between ASA and W groups during the follow-up period. In the 259 patients with a CHA2DS2-VASc score > or =2, there were no significant differences in thromboembolism (0.8% and 2.2%, p=0.380) or major bleeding incidences (0.8% and 1.4%, p=0.640) between ASA and W groups.CONCLUSION:
Switching warfarin to aspirin 3 months after successful RFCA of AF could be as safe and efficacious as long-term anticoagulation even in patients with CHA2DS2-VASc score > or =2. However, strict rhythm monitoring cannot be overemphasized.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Complications
/
Atrial Fibrillation
/
Thromboembolism
/
Warfarin
/
Aspirin
/
Retrospective Studies
/
Treatment Outcome
/
Catheter Ablation
/
Risk Assessment
/
Kaplan-Meier Estimate
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Yonsei Medical Journal
Year:
2014
Type:
Article
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