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https://www.readbyqxmd.com/read/29672182/oral-anticoagulant-use-in-cardiovascular-disorders-a-perspective-on-present-and-potential-indications-for-rivaroxaban
#1
A John Camm, Keith A A Fox
BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) have been approved for use in various cardiovascular indications. The direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors apixaban, edoxaban, and rivaroxaban are now increasingly used in clinical practice. For some of these agents, available data from real-world studies support the efficacy and safety data in phase III clinical trials. OBJECTIVES: This review aims to summarize the current status of trials and observational studies of oral anticoagulant use over the spectrum of cardiovascular disorders (excluding venous thrombosis), provide a reference source beyond stroke prevention for atrial fibrillation (AF) and examine the potential for novel applications in the cardiovascular field...
April 19, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29663464/uninterrupted-administration-of-edoxaban-vs-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation-rationale-and-design-of-the-eliminate-af-study
#2
Stefan H Hohnloser, John Camm, Riccardo Cappato, Hans-Christoph Diener, Hein Heidbuchel, Hans-Joachim Lanz, Lluís Mont, Carlos A Morillo, Rüdiger Smolnik, Ophelia Q P Yin, Josef Kautzner
Patients with atrial fibrillation (AF) are at an approximately 0.5% to 3% increased risk of thromboembolism during and immediately after catheter ablation. Treatment guidelines recommend periprocedural oral anticoagulation plus unfractionated heparin during ablation. Rivaroxaban and dabigatran are the only non-vitamin K oral anticoagulants for which there are randomized controlled trials assessing uninterrupted anticoagulation in patients undergoing catheter ablation of AF. Edoxaban, a direct factor Xa inhibitor, is noninferior vs warfarin for the prevention of stroke or systemic embolism with less major bleeding in patients with nonvalvular AF...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29657590/comparison-of-uninterrupted-anticoagulation-with-dabigatran-etexilate-or-warfarin-in-the-periprocedural-period-for-atrial-fibrillation-catheter-ablation-results-of-the-japanese-subgroup-of-the-re-circuit-trial
#3
Yukihiko Yoshida, Masato Watarai, Kenshi Fujii, Wataru Shimizu, Kazuhiro Satomi, Yasuya Inden, Yoshimasa Murakami, Masato Murakami, Atsushi Iwasa, Masaomi Kimura, Nobuko Yamada, Tomofumi Nakagawa, Matias Nordaby, Ken Okumura
Background: There are limited data on uninterrupted anticoagulation with direct oral anticoagulants during catheter ablation for atrial fibrillation (AF), particularly in Japan. We planned a subgroup analysis of the RE-CIRCUIT study, comparing the use of uninterrupted dabigatran therapy with warfarin therapy during catheter ablation among the Japanese subgroup and with that in the total population. Methods: The RE-CIRCUIT study utilized a prospective, randomized, open-label, blinded endpoint design, and the primary endpoint was the incidence of major bleeding events (MBEs)...
April 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29605015/left-atrial-thrombus-and-dense-spontaneous-echocardiographic-contrast-in-patients-on-continuous-direct-oral-anticoagulant-therapy-undergoing-catheter-ablation-of-atrial-fibrillation-comparison-of-dabigatran-rivaroxaban-and-apixaban
#4
Michael Wu, James Gabriels, Mohammad Khan, Nada Shaban, Salvatore D'Amato, Christopher F Liu, Steven M Markowitz, James E Ip, George Thomas, Parmanand Singh, Bruce Lerman, Apoor Patel, Jim W Cheung
BACKGROUND: Left atrial thrombus (LAT) and dense spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography (TEE) in patients on continuous direct oral anticoagulants (DOAC) therapy before catheter ablation of atrial fibrillation (AF) or atrial flutter (AFL) have been described. OBJECTIVE: We sought to compare rates of TEE-detected LAT and dense SEC among patients taking different DOACs. METHODS: We evaluated 609 consecutive patients from 3 tertiary hospitals (median age 65 years; interquartile range 58-71 years; 436 (72%) men) who were on ≥4 weeks of continuous DOAC therapy (dabigatran, n = 166 [27%]; rivaroxaban, n = 257 [42%]; or apixaban, n = 186 [31%]) undergoing TEE before catheter ablation of AF/AFL...
April 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29368193/periprocedural-anticoagulation-management-for-atrial-fibrillation-ablation-current-knowledge-and-future-directions
#5
REVIEW
Alan Sugrue, Konstantinos C Siontis, Jonathan P Piccini, Peter A Noseworthy
Catheter ablation (CA) for atrial fibrillation (AF) is an established first-line approach to the management of drug-refractory AF. Although, advancements in procedural techniques and technology have improved the efficacy and safety of CA, thromboembolism (TE) remains one of the most feared periprocedural complications. Minimizing the risk of TE during and after CA requires a multifaceted approach, in which periprocedural anticoagulation plays a central role. The goal of anticoagulation before, during, and after CA is to minimize TE risk without excessively increasing the risk of adverse bleeding...
January 25, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29339167/comparison-of-anticoagulant-therapy-for-atrial-fibrillation-novel-oral-anticoagulants-versus-vitamin-k-antagonists
#6
REVIEW
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29296576/first-report-of-dabigatran-reversal-in-iatrogenic-pericardial-tamponade-during-catheter-ablation-of-atrial-fibrillation
#7
Jared D Miller, Jeffrey A Brinker, David D Spragg
No abstract text is available yet for this article.
December 2017: HeartRhythm Case Reports
https://www.readbyqxmd.com/read/29121724/noacs-and-atrial-fibrillation-incidence-and-predictors-of-left-atrial-thrombus-in-the-real-world
#8
Emanuele Bertaglia, Matteo Anselmino, Alessandro Zorzi, Vincenzo Russo, Elisabetta Toso, Francesco Peruzza, Antonio Rapacciuolo, Federico Migliore, Fiorenzo Gaita, Umberto Cucchini, Marcello De Divitiis, Sabino Iliceto, Giuseppe Stabile
AIMS: Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA2 DS2 -VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28972957/comparison-of-different-oral-anticoagulant-regimens-in-patients-with-atrial-fibrillation-undergoing-ablation-or-cardioversion
#9
Monika Gawałko, Agnieszka Kapłon-Cieślicka, Monika Budnik, Aldona Babiarz, Aleksandra Bodys, Robert Uliński, Maciej Żochowski, Michał Peller, Piotr Scisło, Janusz Kochanowski, Krzysztof J Filipiak, Grzegorz Opolski
INTRODUCTION    Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative to vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF). OBJECTIVES    The aim of the study was to assess the incidence of left atrial appendage (LAA) thrombus and dense spontaneous echo contrast (SEC), as well as to compare the clinical characteristics of patients with AF treated with different anticoagulant regimens. PATIENTS AND METHODS    We studied 1033 consecutive patients with AF, who underwent transesophageal echocardiography (TEE) before AF ablation or cardioversion...
December 22, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28846806/apixaban-rivaroxaban-and-dabigatran-use-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-using-the-second-generation-cryoballoon
#10
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation. HYPOTHESIS: We hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs. METHODS: In 200 consecutive patients (mean age, 64...
November 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28844510/meta-analysis-of-effectiveness-and-safety-of-oral-anticoagulants-in-atrial-fibrillation-with-focus-on-apixaban
#11
REVIEW
Ying Bai, Xu-Bo Shi, Chang-Sheng Ma, Gregory Y H Lip
We performed a meta-analysis of data on the effectiveness and safety of apixaban compared with other oral anticoagulants (warfarin or rivaroxaban or dabigatran or edoxaban) for stroke prevention in atrial fibrillation (AF) in different settings of randomized controlled trials, real-world studies, and radiofrequency ablation (RFA). Thirty studies were searched in PubMed, the Cochrane Library, and Clinicaltrials.gov databases reporting comparative effectiveness and safety of apixaban with warfarin (n = 23), rivaroxaban (n = 12), dabigatran (n = 13), or edoxaban (n = 2) for stroke prevention in AF...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28767344/uninterrupted-dabigatran-versus-warfarin-for-ablation-in-atrial-fibrillation
#12
LETTER
Stephen J Seligman
New England Journal of Medicine, Volume 377, Issue 5, Page 494-496, August 2017.
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28767343/uninterrupted-dabigatran-versus-warfarin-for-ablation-in-atrial-fibrillation
#13
LETTER
Hugh Calkins, Matias Nordaby
No abstract text is available yet for this article.
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28656778/common-atrial-flutter-catheter-ablation-without-discontinuing-oral-anticoagulation
#14
Carlos Escobar, Sergio Castrejón, Rosa Montes de Oca, Marta Ortega, José Luis Lopez-Sendon, José Luis Merino
AIM: To determine if performing catheter ablation under oral anticoagulation is associated with a higher risk of thromboembolic or bleeding complications. METHODS: Patients with common atrial flutter that underwent catheter ablation of the cavo-tricuspid isthmus were consecutively included in the study. All patients were taking oral anticoagulants at least 3 weeks before the ablation. RESULTS: A total of 102 patients (mean age 67.9 ± 10.3 years; 83...
June 28, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28607611/report-of-periprocedural-oral-anticoagulants-in-catheter-ablation-for-atrial-fibrillation-the-japanese-catheter-ablation-registry-of-atrial-fibrillation-j-caraf
#15
Yuji Murakawa, Akihiko Nogami, Morio Shoda, Koichi Inoue, Shigeto Naito, Koichiro Kumagai, Yasushi Miyauchi, Teiichi Yamane, Norishige Morita, Hideo Mitamura, Ken Okumura, Kenzo Hirao
BACKGROUND: To obtain a perspective of the current status of catheter ablation for the cure of atrial fibrillation, the Japanese Heart Rhythm Society conducted a nationwide survey: the Japanese Catheter Ablation Registry of Atrial Fibrillation. In this report, we aimed to evaluate the periprocedural use of direct oral anticoagulants with respect to thromboembolic or bleeding complications. METHODS: Using an online questionnaire, the Japanese Heart Rhythm Society requested electrophysiology centers in Japan to register the relevant data of patients who underwent atrial fibrillation ablation over selected five-months from 2011 to 2014...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28532773/comparison-of-the-incidences-of-complications-after-second-generation-cryoballoon-ablation-of-atrial-fibrillation-using-vitamin-k-antagonists-versus-novel-oral-anticoagulants
#16
MULTICENTER STUDY
Giacomo Mugnai, Carlo de Asmundis, Saverio Iacopino, Erwin Stroker, Massimo Longobardi, Valentina De Regibus, Hugo Enrique Coutino-Moreno, Ken Takarada, Rajin Choudhury, Juan Pablo Abugattas de Torres, Cesare Storti, Pedro Brugada, Gian-Battista Chierchia
Data evaluating the impact of the periprocedural administration of novel oral anticoagulants (NOACs) on complications in the setting of pulmonary vein (PV) isolation using cryoballoon (CB) is limited. In the present study, our aim was to analyze procedural characteristics and incidence of complications in those patients who underwent CB ablation for atrial fibrillation and the impact of NOACs on adverse events compared with vitamin K antagonists (VKAs). Consecutive patients with drug resistant atrial fibrillation who underwent PV isolation by CB as index procedure were retrospectively included in our analysis...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28529736/use-of-dabigatran-vs-warfarin-with-low-molecular-weight-heparin-bridging-in-catheter-ablation-for-atrial-fibrillation-patients-with-a-low-chads2-score
#17
Li Hao, Bing Rong, Fei Xie, Ming-Jie Lin, Jing-Quan Zhong
The purpose of the present study was to compare the efficacy and safety of dabigatran and interrupted warfarin with low-molecular-weight heparin bridging in non-valvular atrial fibrillation (AF) catheter ablation. Previously, there has been concerns that bridging therapy increases bleeding events without the benefit of stroke prevention. It has been suggested that bridging therapy should be considered only for patients at high-risk of thrombosis. Nevertheless, bridging therapy in AF patients with a low CHADS2 score may be safe and effective...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28466408/incidence-and-predictors-of-silent-cerebral-thromboembolic-lesions-after-catheter-ablation-for-atrial-fibrillation-in-patients-treated-with-direct-oral-anticoagulants
#18
Atsushi Doi, Masahiko Takagi, Jun Kakihara, Yusuke Hayashi, Hiroaki Tatsumi, Kohei Fujimoto, Kenichi Sugioka, Minoru Yoshiyama
There are few reports about the incidence and predictors of silent cerebral thromboembolic lesions (SCLs) after atrial fibrillation (AF) ablation in patients treated with direct oral anticoagulants (DOACs). The purpose of this study is to evaluate the incidence and predictors of SCLs after AF ablation with cerebral magnetic resonance imaging (C-MRI) in patients treated with DOACs. We enrolled 117 consecutive patients who underwent first AF ablation and received DOACs, including apixaban, dabigatran, edoxaban, and rivaroxaban...
October 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28361980/anticoagulation-therapy-uninterrupted-dabigatran-during-ablation-for-af
#19
Dario Ummarino
No abstract text is available yet for this article.
May 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28317415/uninterrupted-dabigatran-versus-warfarin-for-ablation-in-atrial-fibrillation
#20
RANDOMIZED CONTROLLED TRIAL
Hugh Calkins, Stephan Willems, Edward P Gerstenfeld, Atul Verma, Richard Schilling, Stefan H Hohnloser, Ken Okumura, Harvey Serota, Matias Nordaby, Kelly Guiver, Branislav Biss, Marc A Brouwer, Massimo Grimaldi
BACKGROUND: Catheter ablation of atrial fibrillation is typically performed with uninterrupted anticoagulation with warfarin or interrupted non-vitamin K antagonist oral anticoagulant therapy. Uninterrupted anticoagulation with a non-vitamin K antagonist oral anticoagulant, such as dabigatran, may be safer; however, controlled data are lacking. We investigated the safety of uninterrupted dabigatran versus warfarin in patients undergoing ablation of atrial fibrillation. METHODS: In this randomized, open-label, multicenter, controlled trial with blinded adjudicated end-point assessments, we randomly assigned patients scheduled for catheter ablation of paroxysmal or persistent atrial fibrillation to receive either dabigatran (150 mg twice daily) or warfarin (target international normalized ratio, 2...
April 27, 2017: New England Journal of Medicine
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