Thromboembolic and bleeding risks in patients undergoing atrial fibrillation ablation

oral anticoagulation perspectives

David F. Briceño, Nidhi Madan, Jorge E. Romero, Alejandra Londoño, Pedro A. Villablanca, Andrea Natale, Luigi Di Biase

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Introduction: Atrial fibrillation (AF) is a cause of significant morbidity and mortality. Catheter ablation for AF (CAAF) has emerged as an effective treatment option of rhythm control for patients with symptomatic AF. However, the risk of thromboembolism and bleeding in the periprocedural period represent a worrisome complication of this therapy. The reported incidence of thromboembolic and bleeding events associated with CAAF varies from 0.9% to 5% depending on the CAAF strategy and the anticoagulation regimen used in the periprocedural period. Areas covered: The different anticoagulation regimens used prior to, during, and after CAAF to minimize the risk of thromboembolic and bleeding events are reviewed. The use of uninterrupted oral anticoagulation and appropriate heparin dosing to achieve safe activated clotting time levels are also detailed. A comprehensive approach with assessment of individual risk for thromboembolic and bleeding complications, and understanding the pharmacokinetics of the anticoagulant agents available is also reviewed. Expert opinion: The key advances done in the periprocedural anticoagulation field include the use of uninterrupted anticoagulation strategies in patients undergoing AF ablation and efforts to simplify the selection of patients who need LAA thrombus screening prior to ablation.

Original languageEnglish (US)
Pages (from-to)769-777
Number of pages9
JournalExpert Opinion on Drug Safety
Volume16
Issue number7
DOIs
StatePublished - Jul 3 2017

Fingerprint

Catheter Ablation
Atrial Fibrillation
Hemorrhage
Thromboembolism
Expert Testimony
Anticoagulants
Patient Selection
Heparin
Thrombosis
Pharmacokinetics
Morbidity
Mortality
Incidence
Therapeutics

Keywords

  • anticoagulation
  • Atrial fibrillation
  • bleeding
  • catheter ablation
  • thromboembolism

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Thromboembolic and bleeding risks in patients undergoing atrial fibrillation ablation : oral anticoagulation perspectives. / Briceño, David F.; Madan, Nidhi; Romero, Jorge E.; Londoño, Alejandra; Villablanca, Pedro A.; Natale, Andrea; Di Biase, Luigi.

In: Expert Opinion on Drug Safety, Vol. 16, No. 7, 03.07.2017, p. 769-777.

Research output: Contribution to journalReview article

Briceño, David F. ; Madan, Nidhi ; Romero, Jorge E. ; Londoño, Alejandra ; Villablanca, Pedro A. ; Natale, Andrea ; Di Biase, Luigi. / Thromboembolic and bleeding risks in patients undergoing atrial fibrillation ablation : oral anticoagulation perspectives. In: Expert Opinion on Drug Safety. 2017 ; Vol. 16, No. 7. pp. 769-777.
@article{9a64096ac3d24dc090415aea88fe7649,
title = "Thromboembolic and bleeding risks in patients undergoing atrial fibrillation ablation: oral anticoagulation perspectives",
abstract = "Introduction: Atrial fibrillation (AF) is a cause of significant morbidity and mortality. Catheter ablation for AF (CAAF) has emerged as an effective treatment option of rhythm control for patients with symptomatic AF. However, the risk of thromboembolism and bleeding in the periprocedural period represent a worrisome complication of this therapy. The reported incidence of thromboembolic and bleeding events associated with CAAF varies from 0.9{\%} to 5{\%} depending on the CAAF strategy and the anticoagulation regimen used in the periprocedural period. Areas covered: The different anticoagulation regimens used prior to, during, and after CAAF to minimize the risk of thromboembolic and bleeding events are reviewed. The use of uninterrupted oral anticoagulation and appropriate heparin dosing to achieve safe activated clotting time levels are also detailed. A comprehensive approach with assessment of individual risk for thromboembolic and bleeding complications, and understanding the pharmacokinetics of the anticoagulant agents available is also reviewed. Expert opinion: The key advances done in the periprocedural anticoagulation field include the use of uninterrupted anticoagulation strategies in patients undergoing AF ablation and efforts to simplify the selection of patients who need LAA thrombus screening prior to ablation.",
keywords = "anticoagulation, Atrial fibrillation, bleeding, catheter ablation, thromboembolism",
author = "Brice{\~n}o, {David F.} and Nidhi Madan and Romero, {Jorge E.} and Alejandra Londo{\~n}o and Villablanca, {Pedro A.} and Andrea Natale and {Di Biase}, Luigi",
year = "2017",
month = "7",
day = "3",
doi = "10.1080/14740338.2017.1325867",
language = "English (US)",
volume = "16",
pages = "769--777",
journal = "Expert Opinion on Drug Safety",
issn = "1474-0338",
publisher = "Informa Healthcare",
number = "7",

}

TY - JOUR

T1 - Thromboembolic and bleeding risks in patients undergoing atrial fibrillation ablation

T2 - oral anticoagulation perspectives

AU - Briceño, David F.

AU - Madan, Nidhi

AU - Romero, Jorge E.

AU - Londoño, Alejandra

AU - Villablanca, Pedro A.

AU - Natale, Andrea

AU - Di Biase, Luigi

PY - 2017/7/3

Y1 - 2017/7/3

N2 - Introduction: Atrial fibrillation (AF) is a cause of significant morbidity and mortality. Catheter ablation for AF (CAAF) has emerged as an effective treatment option of rhythm control for patients with symptomatic AF. However, the risk of thromboembolism and bleeding in the periprocedural period represent a worrisome complication of this therapy. The reported incidence of thromboembolic and bleeding events associated with CAAF varies from 0.9% to 5% depending on the CAAF strategy and the anticoagulation regimen used in the periprocedural period. Areas covered: The different anticoagulation regimens used prior to, during, and after CAAF to minimize the risk of thromboembolic and bleeding events are reviewed. The use of uninterrupted oral anticoagulation and appropriate heparin dosing to achieve safe activated clotting time levels are also detailed. A comprehensive approach with assessment of individual risk for thromboembolic and bleeding complications, and understanding the pharmacokinetics of the anticoagulant agents available is also reviewed. Expert opinion: The key advances done in the periprocedural anticoagulation field include the use of uninterrupted anticoagulation strategies in patients undergoing AF ablation and efforts to simplify the selection of patients who need LAA thrombus screening prior to ablation.

AB - Introduction: Atrial fibrillation (AF) is a cause of significant morbidity and mortality. Catheter ablation for AF (CAAF) has emerged as an effective treatment option of rhythm control for patients with symptomatic AF. However, the risk of thromboembolism and bleeding in the periprocedural period represent a worrisome complication of this therapy. The reported incidence of thromboembolic and bleeding events associated with CAAF varies from 0.9% to 5% depending on the CAAF strategy and the anticoagulation regimen used in the periprocedural period. Areas covered: The different anticoagulation regimens used prior to, during, and after CAAF to minimize the risk of thromboembolic and bleeding events are reviewed. The use of uninterrupted oral anticoagulation and appropriate heparin dosing to achieve safe activated clotting time levels are also detailed. A comprehensive approach with assessment of individual risk for thromboembolic and bleeding complications, and understanding the pharmacokinetics of the anticoagulant agents available is also reviewed. Expert opinion: The key advances done in the periprocedural anticoagulation field include the use of uninterrupted anticoagulation strategies in patients undergoing AF ablation and efforts to simplify the selection of patients who need LAA thrombus screening prior to ablation.

KW - anticoagulation

KW - Atrial fibrillation

KW - bleeding

KW - catheter ablation

KW - thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=85021395060&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021395060&partnerID=8YFLogxK

U2 - 10.1080/14740338.2017.1325867

DO - 10.1080/14740338.2017.1325867

M3 - Review article

VL - 16

SP - 769

EP - 777

JO - Expert Opinion on Drug Safety

JF - Expert Opinion on Drug Safety

SN - 1474-0338

IS - 7

ER -