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Safety of Catheter Ablation of Atrial Fibrillation Under Uninterrupted Rivaroxaban Use.
Silva, Márcio Augusto; Futuro, Guilherme Muller de Campos; Merçon, Erick Sessa; Vasconcelos, Deborah; Agrizzi, Rovana Silva; Elias Neto, Jorge; Kuniyoshi, Ricardo.
Afiliação
  • Silva MA; Vitória Apart Hospital, Serra, ES - Brazil.
  • Futuro GMC; Vitória Apart Hospital, Serra, ES - Brazil.
  • Merçon ES; Vitória Apart Hospital, Serra, ES - Brazil.
  • Vasconcelos D; Vitória Apart Hospital, Serra, ES - Brazil.
  • Agrizzi RS; Vitória Apart Hospital, Serra, ES - Brazil.
  • Elias Neto J; Vitória Apart Hospital, Serra, ES - Brazil.
  • Kuniyoshi R; Vitória Apart Hospital, Serra, ES - Brazil.
Arq Bras Cardiol ; 114(3): 435-442, 2020 03.
Article em En, Pt | MEDLINE | ID: mdl-32049156
BACKGROUND: Atrial fibrillation (AF) ablation under uninterrupted warfarin use is safe and recommended by experts. However, there is some controversy regarding direct-acting oral anticoagulants for the same purpose. OBJECTIVE: To evaluate the safety of AF ablation under uninterrupted anticoagulation with rivaroxaban. METHODS: A series of 130 patients underwent AF radiofrequency ablation under uninterrupted rivaroxaban use (RIV group) and was compared to a control group of 110 patients under uninterrupted warfarin use (WFR group) and therapeutic International Normalized Ratio (INR). We analyzed death, rates of thromboembolic events, major and minor bleedings, activated clotting time (ACT) levels, and heparin dose in the procedure. The ablation protocol basically consisted of circumferential isolation of the pulmonary veins guided by electroanatomic mapping. It was adopted a statistical significance of 5%. RESULTS: The clinical characteristics of the groups were similar, and the paroxysmal AF was the most frequent type (63% and 59%, RIV and WFR groups). A thromboembolic event occurred in the RIV group. There were 3 patients with major bleeding (RIV = 1 and WFR = 2; p = 0.5); no deaths. Basal INR was higher in the WFR group (2.5 vs. 1.2 ± 0.02; p < 0.0001), with similar basal ACT levels (123.7 ± 3 vs. 118 ± 4; p= 0, 34). A higher dose of venous heparin was used in the RIV group (9,414 ± 199 vs. 6,019 ± 185 IU; p < 0.0001) to maintain similar mean ACT levels during the procedure (350 ± 3 vs. 348.9 ± 4; p = 0.79). CONCLUSION: In the study population, AF ablation under uninterrupted rivaroxaban showed a safety profile that was equivalent to uninterrupted warfarin use with therapeutic INR.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Ablação por Cateter Idioma: En / Pt Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fibrilação Atrial / Ablação por Cateter Idioma: En / Pt Ano de publicação: 2020 Tipo de documento: Article