Objective To observe the
safety and
efficacy of different periprocedural anticoagulation
strategies in
patients undergoing
catheter ablation of atrial ifbrillation.
Methods Eighty-five
patients aged over 75 undergoing
catheter ablation of
atrial fibrillation from Jul 2011 to Nov 2013 were enrolled. They all took
warfarin and transesophageal echocardiograms were performed to rule out
left atrium appendage
thrombus before ablation. They were divided into 3 groups. In Group 1 (30 cases),
warfarin was stopped and bridged with
low molecular weight heparin (
LMWH ) 3 days before
procedure and
LMWH bridging followed by
warfarin alone after
procedure . In Group 2 (32 cases),
warfarin was continued during periprocedural period. In Group 3 (23 cases),
Dabigatran or
Rivaroxaban alone was used 4 hours after
procedure respectively.
Unfractionated heparin was used during
procedure in all three groups. These three anticoagulation
strategies were compared in
bleeding ,
embolism events and other
complications during 3-month follow-up. Results In Group 1, there were 1 new-onset
ischemic stroke during
hospitalization , 7
lower extremity hematomas , 1
subdural hemorrhage during 3-month follow-up and 6
minor bleeding events. In Group 2, there were 4
lower extremity hematomas and 4
minor bleeding events during 3-month follow-up. As for Group 3, only 2
lower extremity hematomas during
hospitalization was observed in each without any
minor bleeding events during follow-up. Conclusions
Catheter ablation in
elderly atrial ifbrillation
patients was safe and effective in general. Compared with traditional anticoagulation strategy, continuing
warfarin or novel oral
anticoagulants could reduce
bleeding complications without increasing
thromboembolism risk .