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Published in: Journal of Interventional Cardiac Electrophysiology 1/2020

01-06-2020 | Magnetic Resonance Imaging

Feasibility and safety of uninterrupted apixaban in patients undergoing radiofrequency ablation for atrial fibrillation

Authors: Yuki Osaka, Yuichi Ono, Susumu Tao, Kentaro Goto, Toru Miyazaki, Asami Suzuki, Ken Kurihara, Kenichiro Otomo, Kenzo Hirao

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 1/2020

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Abstract

Background

An optimal periprocedural anticoagulation strategy is essential for minimizing bleeding and thromboembolic complications during atrial fibrillation (AF) ablation. Limited data are available on the uninterrupted use of apixaban in patients with AF undergoing catheter ablation. This study aimed to evaluate the safety and efficacy of uninterrupted apixaban in patients undergoing radiofrequency ablation for AF. In particular, we evaluated silent cerebral infarction (CI) during radiofrequency catheter ablation of AF.

Methods

This was a prospective and nonrandomized cohort study. A total of 259 consecutive patients who underwent AF ablation were evaluated; 157 patients received apixaban (Api group), and 102 patients received dose-adjusted (PT-INR 2.0-3.0) warfarin (Wf group). All oral anticoagulants were continued throughout the periprocedural period, including the morning of the procedure. Intravenous heparin was administered during the procedure and neutralized by protamine at the end of the procedure. Sixty-one patients underwent magnetic resonance imaging (MRI) after the procedure to evaluate for silent CI.

Results

Mean age was 66 ± 11 years; there were 91 men (73.7%) and 148 cases of paroxysmal AF (57.1%). No symptomatic CI was observed. Silent CI occurred in 6/61 patients (9.8%). No significant difference was observed between the Api group (4/30 patients, 13.3%) and the Wf group (2/31 patients, 6.5%). There was no significant difference regarding major bleeding events between the Api group (1/157 patients, 0.6%) and the Wf group (2/102 patients, 2.0%).

Conclusions

The safety and efficacy of uninterrupted apixaban for patients undergoing AF ablation were equivalent to warfarin for preventing bleeding and thromboembolic complications.
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Metadata
Title
Feasibility and safety of uninterrupted apixaban in patients undergoing radiofrequency ablation for atrial fibrillation
Authors
Yuki Osaka
Yuichi Ono
Susumu Tao
Kentaro Goto
Toru Miyazaki
Asami Suzuki
Ken Kurihara
Kenichiro Otomo
Kenzo Hirao
Publication date
01-06-2020
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 1/2020
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-019-00563-6

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