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dabigatran ablation

Kimitaka Nishizaki, Taihei Itoh, Masaomi Kimura, Yuichi Tsushima, Yoshihiro Shoji, Takahiko Kinjo, Yuji Ishida, Kenichi Sasaki, Daisuke Horiuchi, Shingo Sasaki, Hirofumi Tomita, Ken Okumura
BACKGROUND: The safety and efficacy of the contemporary atrial fibrillation (AF) ablation in patients with a recent or previous history of cardioembolic stroke (CS) or transient ischemic attack (TIA) remain to be established. METHODS: A total of 447 patients who underwent first-ever contact force (CF)-guided AF ablation with circumferential pulmonary vein isolation were included. Of these, 17 had CS or TIA within 6 months before ablation (Group 1), 30 more than 6 months before ablation (Group 2), and the other 400 without CS or TIA (Group 3)...
November 2, 2016: Journal of Cardiology
Qing Zhang, Yao Qin, Dong-Sheng Zhao, Hai-Ping Zhao, Lei Zhou
OBJECTIVES: Recent research has indicated that red blood cell distribution width (RDW) is associated with the prognosis of cardiovascular diseases such as chronic heart failure and coronary heart disease. We aimed to study the predictive value of RDW for bleeding events in patients with nonvalvular atrial fibrillation (NVAF) during the administration of 110 mg of dabigatran twice a day after catheter ablation. METHODS: One hundred and seventy-two NVAF patients who were hospitalized and received catheter ablation in Jiangsu Provincial People's Hospital from January 2014 to January 2015 were enrolled (110 mg of dabigatran was administered orally to outpatients preoperatively twice a day for 3 weeks)...
November 2, 2016: Cardiology
Cecilia Gutierrez, Daniel G Blanchard
Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, for diagnosis, and suspected atrial fibrillation should be confirmed with 12-lead electrocardiography. Because normal electrocardiographic findings do not rule out atrial fibrillation, home monitoring is recommended if there is clinical suspicion of arrhythmia despite normal test results...
September 15, 2016: American Family Physician
Jannik Langtved Pallisgaard, Gunnar Hilmar Gislason, Christian Torp-Pedersen, Christina Ji-Young Lee, Caroline Sindet-Pedersen, Laila Staerk, Jonas Bjerring Olesen, Tommi Bo Lindhardt
BACKGROUND: Safety regarding switching from vitamin K antagonist (VKA) to dabigatran therapy in post-ablation patients has never been investigated and safety data for this is urgently needed. The objective of this study was to examine if switch from VKA to dabigatran increased the risk of stroke, bleeding, and death in patients after ablation for atrial fibrillation. METHODS: Through the Danish nationwide registries, patients with non-valvular atrial fibrillation undergoing ablation were identified, in the period between August 22nd 2011 and December 31st 2015...
2016: PloS One
Melanie Gunawardene, S Willems, B Schäffer, J Moser, R Ö Akbulak, M Jularic, C Eickholt, J Nührich, C Meyer, P Kuklik, S Sehner, V Czerner, B A Hoffmann
BACKGROUND: The use of non-vitamin K antagonists (NOACs), uninterrupted (uVKA) and interrupted vitamin K antagonists (iVKA) are common periprocedural oral anticoagulation (OAC) strategies for atrial fibrillation (AF) ablation. Comparative data on complication rates resulting from OAC strategies for solely persistent AF (persAF) undergoing ablation are sparse. Thus, we sought to determine the impact of these OAC strategies on complication rates among patients with persAF undergoing catheter ablation...
July 19, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Hirooki Inui, Hidetada Fukuoka, Akihiro Sunaga, Takashi Kanda, Masaaki Uematsu, Shiro Hoshida
The presence of spontaneous echo contrast (SEC) in the left atrium has been reported to be an independent predictor of thromboembolic risk in patients with atrial fibrillation (AF). Dabigatran was associated with lower rates of stroke and systemic embolism as compared with warfarin when administered at a higher dose. Between July 2011 and October 2015, nonvalvular AF patients treated with warfarin or dabigatran who had transesophageal echocardiography prior to ablation therapy for AF were enrolled. The intensity of SEC was classified into four grades, from 0 to 3...
July 12, 2016: Heart and Vessels
Hirosuke Yamaji, Takashi Murakami, Kazuyoshi Hina, Shunich Higashiya, Hiroshi Kawamura, Masaaki Murakami, Shigeshi Kamikawa, Issei Komtasubara, Shozo Kusachi
BACKGROUND AND OBJECTIVE: During atrial fibrillation ablation, heparin is required and is guided by the activated clotting time (ACT). Differences in the ACT before ablation and adequate initial heparin dosing in patients receiving non-vitamin K antagonist oral anticoagulants (NOACs) were examined. METHODS: Patients who received warfarin (control, N = 90), dabigatran etexilate (N = 90), rivaroxaban (N = 90) and apixaban (N = 90) were studied. A 100 U/kg dose of heparin was administered as a reliable control dose for warfarin, and the remaining patients were randomly administered 110, 120 or 130 U/kg of heparin in each NOAC group, followed by a continuous heparin infusion...
October 2016: Clinical Drug Investigation
Kaoru Okishige, Tomofumi Nakamura, Hideshi Aoyagi, Naohiko Kawaguchi, Mitsumi Yamashita, Manabu Kurabayashi, Hidetoshi Suzuki, Mitsutoshi Asano, Tsukasa Shimura, Yasuteru Yamauchi, Tetsuo Sasano, Kenzo Hirao
OBJECTIVE: Few data exist to evaluate the safety and efficacy of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) undergoing cryoballoon ablation (CB-A). This study is aimed to clarify the usefulness of DOACs in patients undergoing CB-A. METHODS: The patients (average age; 65.8±11.9 years old, male 69%) were stratified into one of five subsets based on the type of anticoagulation (warfarin, apixaban, dabigatran, rivaroxaban, or edoxaban), and underwent CB-A...
May 6, 2016: Journal of Cardiology
Akino Yoshimura, Yasuhisa Iriki, Hitoshi Ichiki, Naoya Oketani, Hideki Okui, Ryuichi Maenosono, Fuminori Namino, Masaaki Miyata, Mitsuru Ohishi
BACKGROUND: We previously reported that dabigatran increased the risk of microthromboembolism and hemopericardium compared with warfarin. The safety of non-vitamin-K-antagonist oral anticoagulants (NOACs) in the periprocedural use of atrial fibrillation (AF) ablation is controversial. This study aimed to compare the incidence of asymptomatic cerebral microthromboembolism and hemopericardium in AF ablation among periprocedural use of rivaroxaban, apixaban, and warfarin. METHODS AND RESULTS: This study was a prospective, randomized registry...
April 27, 2016: Journal of Cardiology
Ajay Vallakati, Abhishek Sharma, Mohammed Madmani, Madhu Reddy, Arun Kanmanthareddy, Sampath Gunda, Dhanunjaya Lakkireddy, William R Lewis
INTRODUCTION: Novel oral anticoagulants (NOACs) have been approved for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). A large number of patients are on NOACs when they present for AF ablation. We intended to evaluate the safety and efficacy of NOACs for AF ablation during the periprocedural period by performing a meta-analysis of trials comparing NOACs with warfarin. METHODS: Studies comparing NOACs (dabigatran and rivaroxaban) with warfarin as periprocedural anticoagulants for AF ablation were identified using an electronic search...
June 2016: Cardiology and Therapy
Pei-Jun Li, Jun Xiao, Qing Yang, Yuan Feng, Ting Wang, Guan-Jian Liu, Zong-An Liang
PURPOSE: The aim of this network meta-analysis was to evaluate the comparative efficacy and safety of dabigatran, rivaroxaban, apixaban, interrupted vitamin K antagonist (I-VKA), and continuous VKA (C-VKA) in patients undergoing radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify clinical trials comparing dabigatran, rivaroxaban, or apixaban with I-VKA or C-VKA, or against each other, in AF patients undergoing RFCA...
September 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Takehiro Kimura, Ataru Igarashi, Shunya Ikeda, Kazuaki Nakajima, Shin Kashimura, Akira Kunitomi, Yoshinori Katsumata, Takahiko Nishiyama, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoko Tanimoto, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki
BACKGROUND: We aimed to clarify the cost-effectiveness of an expensive combination therapy for atrial fibrillation (AF) using both catheter ablation and dabigatran compared with warfarin at each CHADS2 score for patients in Japan. METHODS: A Markov model was constructed to analyze costs and quality-adjusted life years associated with AF therapeutic options with a time horizon of 10 years. The target population was 60-year-old patients with paroxysmal AF. The indication for anticoagulation was determined according to the Japanese guideline...
February 29, 2016: Journal of Cardiology
Kohki Nakamura, Shigeto Naito, Takehito Sasaki, Kentaro Minami, Yutaka Take, Eri Goto, Satoru Shimizu, Yoshiaki Yamaguchi, Naoko Suzuki, Toshiaki Yano, Michiharu Senga, Koji Kumagai, Kenichi Kaseno, Nobusada Funabashi, Shigeru Oshima
BACKGROUND: The aim of this study was to identify the predictors of silent cerebral ischemic lesions (SCIL) after catheter ablation of atrial fibrillation (AF) and to determine whether SCIL develop into cerebral infarcts in patients with 5 types of oral anticoagulants (OAC). METHODS AND RESULTS: We retrospectively studied 286 consecutive patients (median, 67 years; 208 male; paroxysmal/persistent/long-standing persistent AF [LSP-AF], 147/90/49) who received periprocedural OAC and underwent MRI after the procedure...
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Buelent Koektuerk, Cem H Turan, Hikmet Yorgun, Kerim Keskin, Moritz Schoett, Alina Dahmen, Eduard Gorr, Alexander Yang, Christian Hoppe, Marc Horlitz, Ramazan G Turan
AIM: Data evaluating the complications of pulmonary vein isolation (PVI) using second-generation cryoballoons (CB) related to different anticoagulation regimes are limited. This study evaluates the total complications and the impact of novel oral anticoagulants (NOACs) compared to phenprocoumon on adverse events in the setting of PVI using CB. METHODS AND RESULTS: PVI was performed using second-generation CB by two experienced investigators. A total of 409 patients (58...
June 2016: Cardiovascular Therapeutics
Peter Steen Hansen, Ricardo Sanchez, Håkan Walfridsson
INTRODUCTION: Limited data are available regarding safety of catheter ablation of atrial fibrillation (AF) in patients using novel oral anticoagulants (NOAC) before and after pulmonary vein isolation. We aimed to assess the safety of a simple anticoagulation protocol in consecutive patients presenting for catheter ablation of AF. METHODS: From November 2011 to December 2014, we prospectively included 234 patients referred for catheter ablation of AF who had already received NOAC treatment...
February 2016: Danish Medical Journal
Masahiko Goya, Akihiko Nogami, Kenzo Hirao, Kazutaka Aonuma
BACKGROUND: Catheter ablation has become a standard treatment strategy for drug-resistant symptomatic non-valvular atrial fibrillation (NVAF). Periprocedural administration of uninterrupted warfarin could reduce the risk of thromboembolic complications. However, only a few retrospective studies have reported on the efficacy and safety of periprocedural dabigatran use. METHOD: ABRIDGE is a prospective, randomized, parallel-group, controlled study that aims to evaluate the efficacy and safety of dabigatran compared with warfarin during the perioperative period of catheter ablation...
September 2016: Journal of Cardiology
Dragos Cozma, Caius Glad Streian, Cristina Vacarescu, Cristian Mornos
BACKGROUND AND AIM: To assess the safety of dabigatran in converting persistent atrial fibrillation (PAF) and atrial flutter (AFL) to sinus rhythm (SR) without transoesophageal echocardiography (TEE) evaluation. METHODS: Consecutive patients with PAF or AFL were included between 2012 and 2015. Dabigatran was used for three weeks before and six months after cardioversion. Left atrium area (LAA) and left atrium volume (LAV) were assessed in all patients. Follow-up visits for major cardiac events occurred at 1, 3, 6, and 12 months...
2016: Kardiologia Polska
Andreas Rillig, Tina Lin, Joaquina Plesman, Christian-H Heeger, Christine Lemes, Andreas Metzner, Shibu Mathew, Erik Wissner, Peter Wohlmuth, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz
INTRODUCTION: Data on the novel oral anticoagulants (NOACS) during catheter ablation (CA) of atrial fibrillation (AF) are still limited. This study evaluated the periprocedural major complications (MC) of CA of AF, and compared Apixaban, Dabigatran, and Rivaroxaban with continuous phenoprocoumon. METHODS AND RESULTS: A total of 444 patients (mean age = 65.1 ± 9.4 years; 283 [64%] male) with paroxysmal (n = 180 [41%]), persistent (n = 256 [58%]), or longstanding-persistent AF were enrolled...
February 2016: Journal of Cardiovascular Electrophysiology
Dasheng Lu, Qi Zhang, Qian Liu, Kai Wang, Shengchan Wang, Qijun Shan
BACKGROUND: Comprehensive comparisons of safety (measured by bleeding risk) between multiple novel oral anticoagulants (NOACs and warfarin) in the peri-procedural period of catheter ablation (CA) for atrial fibrillation (AF) are rare. METHODS AND RESULTS: MEDLINE, EMBASE, and COCHRANE LIBRARY were searched up to February 2015 by two reviewers independently. Predefined inclusion criteria identified 24 studies which were included in the analysis. Data were extracted by two researchers, and a network meta-analysis was conducted in R with R2WinBugS package, within Bayesian framework...
November 2015: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Yuji Murakawa, Akihiko Nogami, Morio Shoda, Koichi Inoue, Shigeto Naito, Koichiro Kumagai, Yasushi Miyauchi, Teiichi Yamane, Norishige Morita, Hideo Mitamura, Ken Okumura
BACKGROUND: Catheter ablation has become an established therapy for the treatment of atrial fibrillation (AF). To obtain a perspective on the current status of this therapy in Japan, the Japanese Heart Rhythm Society (JHRS) conducted a nationwide survey, the Japanese Catheter Ablation Registry of Atrial Fibrillation (J-CARAF). In this study, we focused on whether periprocedural use of novel oral anticoagulants (NOACs) was related with excessive thromboembolic or bleeding complications...
February 2015: Journal of Arrhythmia
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