Impact of periprocedural anticoagulation therapy on the incidence of silent stroke after atrial fibrillation ablation in patients receiving direct oral anticoagulants : uninterrupted vs. interrupted by one dose strategy
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissionsoup.com..
AIMS: Data on the comparison between uninterrupted and interrupted by one dose strategies for direct oral anticoagulant (DOAC) use during the periprocedural period of atrial fibrillation (AF) ablation are scarce. The purpose of this study is to investigate the feasibility of uninterrupted DOAC strategy by evaluating the incidence of silent stroke (SS) and perioperative trends in coagulation markers compared with the interrupted strategy.
METHODS AND RESULTS: We randomly divided 200 consecutive patients receiving DOACs, who underwent AF ablation into uninterrupted group (UG = 100) and interrupted by one dose group (IG = 100). The rate of SS confirmed by post-operative magnetic resonance imaging and periprocedural trends in coagulation markers was investigated. A significant difference in SS incidence was found between the UG and IG (UG 4%, IG 17%, P < 0.005), although there were no differences in the rate of complications including bleeding and symptomatic thrombo-embolic events between the two groups. Intraoperative cardioversion [odds ratio (OR) 7.27, 95% confidence interval (CI) 1.76-30.0; P < 0.01] and the length of procedure time (OR 1.03, 95% CI 1.01-1.05; P < 0.05) independently predicted the occurrence of SS in the IG. A significant increase in prothrombin fragment 1 + 2 (PF1 + 2) values was observed in the IG compared with the UG on the operative and first post-operative days.
CONCLUSION: Silent stroke incidence in the IG was significantly higher than that in the UG; this seems to be supported by the difference in PF1 + 2 values between the UG and IG. Intraoperative cardioversion and procedure time predicted the occurrence of SS in the IG.
| Errataetall: |
CommentIn: Europace. 2019 Apr 1;21(4):531-532. - PMID 30496402 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
|---|---|
| Enthalten in: |
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology - 21(2019), 4 vom: 01. Apr., Seite 590-597 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Nagao, Tomoyuki [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 05.10.2020 Date Revised 05.10.2020 published: Print CommentIn: Europace. 2019 Apr 1;21(4):531-532. - PMID 30496402 Citation Status MEDLINE |
|---|
| doi: |
10.1093/europace/euy224 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM29009741X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM29009741X | ||
| 003 | DE-627 | ||
| 005 | 20231225064005.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2019 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/europace/euy224 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0966.xml |
| 035 | |a (DE-627)NLM29009741X | ||
| 035 | |a (NLM)30376051 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Nagao, Tomoyuki |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of periprocedural anticoagulation therapy on the incidence of silent stroke after atrial fibrillation ablation in patients receiving direct oral anticoagulants |b uninterrupted vs. interrupted by one dose strategy |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 05.10.2020 | ||
| 500 | |a Date Revised 05.10.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Europace. 2019 Apr 1;21(4):531-532. - PMID 30496402 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: Data on the comparison between uninterrupted and interrupted by one dose strategies for direct oral anticoagulant (DOAC) use during the periprocedural period of atrial fibrillation (AF) ablation are scarce. The purpose of this study is to investigate the feasibility of uninterrupted DOAC strategy by evaluating the incidence of silent stroke (SS) and perioperative trends in coagulation markers compared with the interrupted strategy | ||
| 520 | |a METHODS AND RESULTS: We randomly divided 200 consecutive patients receiving DOACs, who underwent AF ablation into uninterrupted group (UG = 100) and interrupted by one dose group (IG = 100). The rate of SS confirmed by post-operative magnetic resonance imaging and periprocedural trends in coagulation markers was investigated. A significant difference in SS incidence was found between the UG and IG (UG 4%, IG 17%, P < 0.005), although there were no differences in the rate of complications including bleeding and symptomatic thrombo-embolic events between the two groups. Intraoperative cardioversion [odds ratio (OR) 7.27, 95% confidence interval (CI) 1.76-30.0; P < 0.01] and the length of procedure time (OR 1.03, 95% CI 1.01-1.05; P < 0.05) independently predicted the occurrence of SS in the IG. A significant increase in prothrombin fragment 1 + 2 (PF1 + 2) values was observed in the IG compared with the UG on the operative and first post-operative days | ||
| 520 | |a CONCLUSION: Silent stroke incidence in the IG was significantly higher than that in the UG; this seems to be supported by the difference in PF1 + 2 values between the UG and IG. Intraoperative cardioversion and procedure time predicted the occurrence of SS in the IG | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Brain magnetic resonance imaging | |
| 650 | 4 | |a Catheter ablation | |
| 650 | 4 | |a Direct oral anticoagulant | |
| 650 | 4 | |a Silent stroke | |
| 650 | 7 | |a Factor Xa Inhibitors |2 NLM | |
| 650 | 7 | |a Peptide Fragments |2 NLM | |
| 650 | 7 | |a Pyrazoles |2 NLM | |
| 650 | 7 | |a Pyridines |2 NLM | |
| 650 | 7 | |a Pyridones |2 NLM | |
| 650 | 7 | |a Thiazoles |2 NLM | |
| 650 | 7 | |a prothrombin fragment 1.2 |2 NLM | |
| 650 | 7 | |a apixaban |2 NLM | |
| 650 | 7 | |a 3Z9Y7UWC1J |2 NLM | |
| 650 | 7 | |a Prothrombin |2 NLM | |
| 650 | 7 | |a 9001-26-7 |2 NLM | |
| 650 | 7 | |a Rivaroxaban |2 NLM | |
| 650 | 7 | |a 9NDF7JZ4M3 |2 NLM | |
| 650 | 7 | |a edoxaban |2 NLM | |
| 650 | 7 | |a NDU3J18APO |2 NLM | |
| 700 | 1 | |a Suzuki, Hitomi |e verfasserin |4 aut | |
| 700 | 1 | |a Matsunaga, Syun |e verfasserin |4 aut | |
| 700 | 1 | |a Nishikawa, Yoshinori |e verfasserin |4 aut | |
| 700 | 1 | |a Harada, Kazuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Mamiya, Kumiko |e verfasserin |4 aut | |
| 700 | 1 | |a Shinoda, Norihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Harada, Ken |e verfasserin |4 aut | |
| 700 | 1 | |a Kato, Masataka |e verfasserin |4 aut | |
| 700 | 1 | |a Marui, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Amano, Tetsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Inden, Yasuya |e verfasserin |4 aut | |
| 700 | 1 | |a Murohara, Toyoaki |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology |d 1999 |g 21(2019), 4 vom: 01. Apr., Seite 590-597 |w (DE-627)NLM111066492 |x 1532-2092 |7 nnns |
| 773 | 1 | 8 | |g volume:21 |g year:2019 |g number:4 |g day:01 |g month:04 |g pages:590-597 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/europace/euy224 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 21 |j 2019 |e 4 |b 01 |c 04 |h 590-597 | ||