Abstract 18972: Are Three Weeks of Oral Anticoagulation Necessary in Patients With Paroxysmal AF Undergoing Ablation With Uninterrupted NOACs?
Background: The duration of pre-procedure anticoagulation before AF ablation with the use of uninterrupted non vitamin K antagonist (NOACs) is unclear in the literature.
Hypothesis: We sought to evaluate whether 3 weeks vs. 2 weeks vs. 1 week of pre-procedural NOACs administration is safe in patients with paroxysmal AF undergoing RF ablation with uninterrupted NOACs.
Methods: We performed a prospective multicenter registry of paroxysmal AF patients with normal ejection fraction undergoing radiofrequency catheter ablation on uninterrupted NOACs (apixaban and rivaroxaban). Patient were categorized based on the duration of pre-ablation NOAC administration into three groups: Group A composed by patients who were on NOACs for at least 3 weeks before ablation, Group B composed by patients who were on NOACs for 2 weeks before ablation and Group C composed by patients who were on NOACs for 1 week before ablation.
Results: A total of 613 patients were enrolled for this study (Group A: 231 patients, Group B: 200 patients, Group C: 182 patients). Baseline characteristics were similar between three groups. Overall, mean age was 63.6± 10.4 years, 201 (33%) patients were on apixaban, 412 (67%) patients were on rivaroxaban and 383 (63%) patients were male. Mean CHA2DS2-VASc score was 1.97 ± 1.4. None of the patients underwent TEE prior to the ablation procedure. There were no thromboembolic complications in three groups. One patient in each group had pericardial effusion (p=0.99) which was resolved by conservative management.
Conclusions: Our study illustrates that in patients with paroxysmal AF performing ablation on uninterrupted apixaban and rivaroxaban without TEE is safe and no difference exist between 3 weeks vs. 2 weeks vs. 1 week of pre ablation NOACs administration. This finding has important clinical and economic relevance.
Author Disclosures: L. Di Biase: Honoraria; Modest; Boston Scientific ,Medtronic, Janssen, Pfizer, Bristol Meyers, EPiEP and Biotronik. Consultant/Advisory Board; Modest; Biosense Webster, Stereotaxis and St Jude Medical. D. Briceno: None. C. Trivedi: None. S. Mohanty: None. C. Gianni: None. R. Horton: None. J. Burkhardt: None. J. Sanchez: None. G. Gallinghouse: None. S. Bailey: None. J. Zagrodzky: None. A. Al-Ahmad: None. P. Hranitzky: None. S. Beheiry: None. R. Hongo: None. D. Lakkireddy: None. A. Natale: Honoraria; Modest; Boston Scientific, Biosense Webster, St. Jude Medical, Biotronik and Medtronic. Consultant/Advisory Board; Modest; Biosense Webster St Jude Medical and Janssen.
- © 2016 by American Heart Association, Inc.