Periprocedural management of anticoagulation for atrial fibrillation catheter ablation in direct oral anticoagulant-treated patients.

ABSTRACT:

Background

Guidelines recommend performing atrial fibrillation (AF) catheter ablation without interruption of a direct oral anticoagulants (DOACs) and to administer unfractionated heparin (UFH) for an activated clotting time (ACT) ≥300 seconds, by analogy with vitamin K antagonist (VKA). Nevertheless, pharmacological differences between DOACs and VKA, especially regarding ACT sensitivity and UFH response, prevent extrapolation from VKA to DOACs.

Hypothesis

The level of anticoagulation at the time of the procedure in uninterrupted DOAC-treated patients is unpredictable and would complicate intraprocedural UFH administration and monitoring.

Methods

This prospective study included interrupted DOAC-treated patients requiring AF ablation. Preprocedural DOAC concentration (

SUBMITTER: Martin AC 

PROVIDER: S-EPMC6489798 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature