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Clotting times for patients with AF ablation vary by oral anticoagulant selection
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The average duration for patients who underwent atrial fibrillation catheter ablation to reach activated clotting time varied based on the type of oral anticoagulants received, according to research published in Heart Rhythm.
“New oral anticoagulants ... have been used during the periprocedural period of atrial fibrillation ablation with the enhancement of use for nonvalvular atrial fibrillation,” the researchers wrote. “However, there is still controversy regarding the most suitable method between interrupted and uninterrupted new oral anticoagulants.”
Tomoyuki Nagao, MD, of the department of cardiology, Nagoya University Graduate School of Medicine, Japan and colleagues studied 869 patients who underwent AF ablation and received uninterrupted periprocedural anticoagulation with oral anticoagulants.
No major differences in baseline characteristics were observed between groups; 499 patients were given newer therapies dabigatran (Pradaxa, Boehringer Ingelheim), rivaroxaban (Xarelto, Janssen Pharmaceuticals) and apixaban (Eliquis, Bristol Myers Squibb) and 370 patients were given warfarin.
The investigators retrospectively assessed changes in intraprocedural activated clotting time among the different anticoagulants and estimated the incidence of periprocedural events. Target activated clotting time was considered greater than 300 seconds.
Patients in the dabigatran group and apixaban group took significantly longer, on average, to reach the target activated clotting time compared with those in the warfarin group and rivaroxaban group (60 min and 70 min vs. 8 min and 9 min, respectively; P < .001).
Further, the percentage of patients who achieved the target time following an initial heparin injection was lower in the dabigatran and apixaban group and compared with the warfarin and rivaroxaban groups (36% and 26% vs. 84% and 78%, respectively; P < .001). The groups had equal incidence of bleeding and/or thromboembolic complications.
“These findings would be useful for the patients with uninterrupted new oral anticoagulants during periprocedural period of AF ablation,” the researchers wrote. - by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.
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