TY - JOUR
T1 - Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation
T2 - Results from a multicenter prospective registry
AU - Lakkireddy, Dhanunjaya
AU - Reddy, Yeruva Madhu
AU - Di Biase, Luigi
AU - Vallakati, Ajay
AU - Mansour, Moussa C.
AU - Santangeli, Pasquale
AU - Gangireddy, Sandeep
AU - Swarup, Vijay
AU - Chalhoub, Fadi
AU - Atkins, Donita
AU - Bommana, Sudharani
AU - Verma, Atul
AU - Sanchez, Javier E.
AU - Burkhardt, J. David
AU - Barrett, Conor D.
AU - Baheiry, Salwa
AU - Ruskin, Jeremy
AU - Reddy, Vivek
AU - Natale, Andrea
N1 - Funding Information:
Dr. Lakkireddy has received speaker honoraria from St. Jude Medical, Boehringer Ingelheim, Jansen, and Bristol Meyers Squibb. Dr. Di Biase is a consultant for Hansen Medical, St. Jude Medical, and Biosense Webster. Dr. Mansour received research grants from Biosense Webster, St. Jude Medical, Boston Scientific, and MC 10 . Dr. Swarup has a research relationship with Biosense Webster, St. Jude Medical, Boston Scientific, Medtronic, and Biotronik. Dr. Verma serves on the advisory boards of Bayer, Boehringer Ingelheim, and Pfizer. Dr. Sanchez has received speaker fees from Janssen. Dr. Burkhardt is a speaker for Boehringer Ingelheim and a consultant with Biosense Webster. Dr. Ruskin has received fellowship grants and/or is a consultant with Biosense Webster, Bristol-Myers Squibb, Boston Scientific, Medtronic, Pfizer, Sanofi-Aventis, St. Jude Medical, and Advanced Medical Education. Dr. Natale is a consultant with Medtronic, Biosense Webster, Boston Scientific, St. Jude Medical, and Biotronik. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Lakkireddy and Reddy contributed equally and are primary coauthors of the manuscript.
PY - 2014/3/18
Y1 - 2014/3/18
N2 - Objectives The purpose of this study was to evaluate the feasibility and safety of uninterrupted rivaroxaban therapy during atrial fibrillation (AF) ablation. Background Optimal periprocedural anticoagulation strategy is essential for minimizing bleeding and thromboembolic complications during and after AF ablation. The safety and efficacy of uninterrupted rivaroxaban therapy as a periprocedural anticoagulant for AF ablation are unknown. Methods We performed a multicenter, observational, prospective study of a registry of patients undergoing AF ablation in 8 centers in North America. Patients taking uninterrupted periprocedural rivaroxaban were matched by age, sex, and type of AF with an equal number of patients taking uninterrupted warfarin therapy who were undergoing AF ablation during the same period. Results A total of 642 patients were included in the study, with 321 in each group. Mean age was 63 ± 10 years, with 442 (69%) males and 328 (51%) patients with paroxysmal AF equally distributed between the 2 groups. Patients in the warfarin group had a slightly higher mean HAS- BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) score (1.70 ± 1.0 vs. 1.47 ± 0.9, respectively; p = 0.032). Bleeding and embolic complications occurred in 47 (7.3%) and 2 (0.3%) patients (both had transient ischemic attacks) respectively. There were no differences in the number of major bleeding complications (5 [1.6%] vs. 7 [1.9%], respectively; p = 0.772), minor bleeding complications (16 [5.0%] vs. 19 [5.9%], respectively; p = 0.602), or embolic complications (1 [0.3%] vs. 1 [0.3%], respectively; p = 1.0) between the rivaroxaban and warfarin groups in the first 30 days. Conclusions Uninterrupted rivaroxaban therapy appears to be as safe and efficacious in preventing bleeding and thromboembolic events in patients undergoing AF ablation as uninterrupted warfarin therapy.
AB - Objectives The purpose of this study was to evaluate the feasibility and safety of uninterrupted rivaroxaban therapy during atrial fibrillation (AF) ablation. Background Optimal periprocedural anticoagulation strategy is essential for minimizing bleeding and thromboembolic complications during and after AF ablation. The safety and efficacy of uninterrupted rivaroxaban therapy as a periprocedural anticoagulant for AF ablation are unknown. Methods We performed a multicenter, observational, prospective study of a registry of patients undergoing AF ablation in 8 centers in North America. Patients taking uninterrupted periprocedural rivaroxaban were matched by age, sex, and type of AF with an equal number of patients taking uninterrupted warfarin therapy who were undergoing AF ablation during the same period. Results A total of 642 patients were included in the study, with 321 in each group. Mean age was 63 ± 10 years, with 442 (69%) males and 328 (51%) patients with paroxysmal AF equally distributed between the 2 groups. Patients in the warfarin group had a slightly higher mean HAS- BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) score (1.70 ± 1.0 vs. 1.47 ± 0.9, respectively; p = 0.032). Bleeding and embolic complications occurred in 47 (7.3%) and 2 (0.3%) patients (both had transient ischemic attacks) respectively. There were no differences in the number of major bleeding complications (5 [1.6%] vs. 7 [1.9%], respectively; p = 0.772), minor bleeding complications (16 [5.0%] vs. 19 [5.9%], respectively; p = 0.602), or embolic complications (1 [0.3%] vs. 1 [0.3%], respectively; p = 1.0) between the rivaroxaban and warfarin groups in the first 30 days. Conclusions Uninterrupted rivaroxaban therapy appears to be as safe and efficacious in preventing bleeding and thromboembolic events in patients undergoing AF ablation as uninterrupted warfarin therapy.
KW - periprocedural anticoagulation
KW - radiofrequency ablation
KW - rivaroxaban
KW - warfarin
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U2 - 10.1016/j.jacc.2013.11.039
DO - 10.1016/j.jacc.2013.11.039
M3 - Article
C2 - 24412445
AN - SCOPUS:84896093558
SN - 0735-1097
VL - 63
SP - 982
EP - 988
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 10
ER -