ABSTRACT
Objective:
To investigate the timing of pericardial
drainage catheter removal and restart of the anticoagulation in
patients with
atrial fibrillation (AF) suffered from perioperative
pericardial tamponade during
atrial fibrillation catheter ablation and uninterrupted
dabigatran.
Methods:
A total of 20
patients with
pericardial tamponade,
who underwent AF
catheter ablation with uninterrupted
dabigatran in
Beijing Anzhen
Hospital from January 2019 to August 2021, were included in this retrospective
analysis. The clinical characteristics of enrolled
patients, information of
catheter ablation procedures,
pericardial tamponade management, perioperative
complications, the timing of pericardial
drainage catheter removal and restart of anticoagulation were analyzed.
Results:
All
patients underwent
pericardiocentesis and
pericardial effusion drainage was successful in all
patients. The average
drainage volume was (427.8±527.4) ml. Seven cases were treated with idarucizumab, of which 1
patient received surgical repair. The average timing of pericardial
drainage catheter removal and restart of anticoagulation in 19
patients without surgical repair was (1.4±0.7) and (0.8±0.4) days, respectively. No new
bleeding,
embolism and
death were reported during
hospitalization and within 30 days following
hospital discharge.
Time of removal of pericardial
drainage catheter, restart of anticoagulation and
hospital stay were
similar between
patients treated with idarucizumab or not.
Conclusion:
It is safe and reasonable to remove pericardial
drainage catheter and restart anticoagulation as soon as possible during
catheter ablation of
atrial fibrillation with uninterrupted
dabigatran independent of the idarucizumab use or not in case of confirmed
hemostasis.