Safety of ablation for atrial fibrillation with therapeutic INR: comparison with transition to low-molecular-weight heparin.
Arq Bras Cardiol
; 97(4): 289-96, 2011 Oct.
Article
em En, Pt
| MEDLINE
| ID: mdl-21861038
ABSTRACT
BACKGROUND:
The ideal management of oral anticoagulation (OAC) before and after catheter ablation for atrial fibrillation (AF) is still controversial.OBJECTIVE:
To compare two anticoagulation strategies for catheter ablation for AF warfarin withholding and use of low-molecular-weight heparin (LMWH); and maintenance of warfarin and therapeutic INR (between 2.0 and 3.0).METHODS:
140 patients (pt) with persistent/permanent AF undergoing catheter ablation for AF were divided into two groups Group I (70 pt), in which warfarin was withheld five days prior to the procedure and transition to LMWH was used (enoxaparin 1 mg/kg 2x/day before ablation, and 0.5 mg/kg 2x/day after ablation); Group II (70 pt), in which warfarin was not withheld and the procedure was performed with therapeutic INR. Both groups received intravenous heparin (ACT > 350 seconds) during ablation.RESULTS:
In Group I, one pt (1.4%) had a major hemorrhagic complication and four pts (5.7%) had minor hemorrhagic complications. In Group II, two pts (2.8%) had minor hemorrhagic complications and one pt had a major bleeding, which occurred after using LMWH due to INR < 2.0. None of the groups had thromboembolic complications or cardiovascular death over a period of 16 ± 8 months.CONCLUSION:
Catheter ablation for AF without withholding OAC and with therapeutic INR is a strategy that has similar safety and efficacy when compared with the traditional transition to LMWH, avoiding the potentially inadequate anticoagulation of the initial post-ablation period.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Varfarina
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Cuidados Pré-Operatórios
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Heparina de Baixo Peso Molecular
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Hemorragia
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Anticoagulantes
Tipo de estudo:
Clinical_trials
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
/
Pt
Revista:
Arq Bras Cardiol
Ano de publicação:
2011
Tipo de documento:
Article