The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation

Giannis Baltogiannis; Gian-Battista Chierchia; Giulio Conte; Juan  Sieira; Giacomo Di Giovanni; Giuseppe Ciconte; Carlo de Asmundis; Yukio Saitoh; Kristel Wauters; Ghazala Irfan; Pedro Brugada

doi:10.1016/j.hjc.2016.11.003

The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation

Giannis Baltogiannis, Gian-Battista Chierchia, Giulio Conte, Juan Sieira, Giacomo Di Giovanni, Giuseppe Ciconte, Carlo de Asmundis, Yukio Saitoh, Kristel Wauters, Ghazala Irfan, Pedro Brugada

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

AIM: Peri-procedural thromboembolic (TE) and hemorrhagic events are complications of major concern for patients undergoing cryoballoon (CB) ablation for atrial fibrillation (AF). While peri-procedural anticoagulation management could decrease the incidence of these complications, data on CB ablation are scarce. The role of novel oral anticoagulants (NOACs) has not been thoroughly tested in this population.

METHODS: In the present study, we sought to assess acute peri-procedural complications in patients undergoing CB ablation for AF under different anticoagulation regimens; anticoagulation administration was performed according to the CHA2DS2-VASc score guidelines. To the best of our knowledge, this is the first study that compares 1) uninterrupted warfarin, 2) bridging therapy with low molecular weight heparin (LMWH), 3) aspirin and 4) NOACs in this subgroup of patients.

RESULTS: NOACs were as effective as uninterrupted warfarin in terms of bleeding complications and TE events. Surprisingly, the aspirin group had more hemorrhagic complications than both the warfarin and NOACs groups.

CONCLUSION: In the current study, the use of NOACs was an effective and safe approach in CB ablation.

Original language	English
Pages (from-to)	331-337
Number of pages	7
Journal	Hellenic Journal of Cardiology
Volume	57
Issue number	5
DOIs	https://doi.org/10.1016/j.hjc.2016.11.003
Publication status	Published - 1 Sep 2016

Keywords

Atrial fibrillation
Cryoballoon ablation
Novel oral Anticoagulants
acetylsalicylic acid
anticoagulant agent
apixaban
dabigatran
heparin
low molecular weight heparin
rivaroxaban
warfarin
ablation catheter
ablation therapy
absence of side effects
adult
aged
article
atrial fibrillation
bleeding
bleeding disorder
cardiovascular disease assessment
catheter
catheter sheath
CHA2DS2-VASc score
comparative study
continuous infusion
controlled study
coronary artery disease
cryoablation
drug efficacy
drug safety
dyslipidemia
female
groin hematoma
HAS BLED score
heart failure
heart left atrium
heart left ventricle ejection fraction
heart tamponade
human
hypertension
lung hemorrhage
major clinical study
male
mapping catheter
middle aged
practice guideline
pulmonary vein

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10.1016/j.hjc.2016.11.003

Cite this

Baltogiannis, Giannis ; Chierchia, Gian-Battista ; Conte, Giulio ; Sieira, Juan ; Di Giovanni, Giacomo ; Ciconte, Giuseppe ; de Asmundis, Carlo ; Saitoh, Yukio ; Wauters, Kristel ; Irfan, Ghazala ; Brugada, Pedro. / The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation. In: Hellenic Journal of Cardiology. 2016 ; Vol. 57, No. 5. pp. 331-337.

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abstract = "AIM: Peri-procedural thromboembolic (TE) and hemorrhagic events are complications of major concern for patients undergoing cryoballoon (CB) ablation for atrial fibrillation (AF). While peri-procedural anticoagulation management could decrease the incidence of these complications, data on CB ablation are scarce. The role of novel oral anticoagulants (NOACs) has not been thoroughly tested in this population.METHODS: In the present study, we sought to assess acute peri-procedural complications in patients undergoing CB ablation for AF under different anticoagulation regimens; anticoagulation administration was performed according to the CHA2DS2-VASc score guidelines. To the best of our knowledge, this is the first study that compares 1) uninterrupted warfarin, 2) bridging therapy with low molecular weight heparin (LMWH), 3) aspirin and 4) NOACs in this subgroup of patients.RESULTS: NOACs were as effective as uninterrupted warfarin in terms of bleeding complications and TE events. Surprisingly, the aspirin group had more hemorrhagic complications than both the warfarin and NOACs groups.CONCLUSION: In the current study, the use of NOACs was an effective and safe approach in CB ablation.",

keywords = "Atrial fibrillation, Cryoballoon ablation, Novel oral Anticoagulants, acetylsalicylic acid, anticoagulant agent, apixaban, dabigatran, heparin, low molecular weight heparin, rivaroxaban, warfarin, ablation catheter, ablation therapy, absence of side effects, adult, aged, article, atrial fibrillation, bleeding, bleeding disorder, cardiovascular disease assessment, catheter, catheter sheath, CHA2DS2-VASc score, comparative study, continuous infusion, controlled study, coronary artery disease, cryoablation, drug efficacy, drug safety, dyslipidemia, female, groin hematoma, HAS BLED score, heart failure, heart left atrium, heart left ventricle ejection fraction, heart tamponade, human, hypertension, lung hemorrhage, major clinical study, male, mapping catheter, middle aged, practice guideline, pulmonary vein",

author = "Giannis Baltogiannis and Gian-Battista Chierchia and Giulio Conte and Juan Sieira and {Di Giovanni}, Giacomo and Giuseppe Ciconte and {de Asmundis}, Carlo and Yukio Saitoh and Kristel Wauters and Ghazala Irfan and Pedro Brugada",

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The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation. / Baltogiannis, Giannis; Chierchia, Gian-Battista ; Conte, Giulio; Sieira, Juan ; Di Giovanni, Giacomo; Ciconte, Giuseppe; de Asmundis, Carlo; Saitoh, Yukio; Wauters, Kristel; Irfan, Ghazala; Brugada, Pedro.

In: Hellenic Journal of Cardiology, Vol. 57, No. 5, 01.09.2016, p. 331-337.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation

AU - Baltogiannis, Giannis

AU - Chierchia, Gian-Battista

AU - Conte, Giulio

AU - Sieira, Juan

AU - Di Giovanni, Giacomo

AU - Ciconte, Giuseppe

AU - de Asmundis, Carlo

AU - Saitoh, Yukio

AU - Wauters, Kristel

AU - Irfan, Ghazala

AU - Brugada, Pedro

PY - 2016/9/1

Y1 - 2016/9/1

N2 - AIM: Peri-procedural thromboembolic (TE) and hemorrhagic events are complications of major concern for patients undergoing cryoballoon (CB) ablation for atrial fibrillation (AF). While peri-procedural anticoagulation management could decrease the incidence of these complications, data on CB ablation are scarce. The role of novel oral anticoagulants (NOACs) has not been thoroughly tested in this population.METHODS: In the present study, we sought to assess acute peri-procedural complications in patients undergoing CB ablation for AF under different anticoagulation regimens; anticoagulation administration was performed according to the CHA2DS2-VASc score guidelines. To the best of our knowledge, this is the first study that compares 1) uninterrupted warfarin, 2) bridging therapy with low molecular weight heparin (LMWH), 3) aspirin and 4) NOACs in this subgroup of patients.RESULTS: NOACs were as effective as uninterrupted warfarin in terms of bleeding complications and TE events. Surprisingly, the aspirin group had more hemorrhagic complications than both the warfarin and NOACs groups.CONCLUSION: In the current study, the use of NOACs was an effective and safe approach in CB ablation.

AB - AIM: Peri-procedural thromboembolic (TE) and hemorrhagic events are complications of major concern for patients undergoing cryoballoon (CB) ablation for atrial fibrillation (AF). While peri-procedural anticoagulation management could decrease the incidence of these complications, data on CB ablation are scarce. The role of novel oral anticoagulants (NOACs) has not been thoroughly tested in this population.METHODS: In the present study, we sought to assess acute peri-procedural complications in patients undergoing CB ablation for AF under different anticoagulation regimens; anticoagulation administration was performed according to the CHA2DS2-VASc score guidelines. To the best of our knowledge, this is the first study that compares 1) uninterrupted warfarin, 2) bridging therapy with low molecular weight heparin (LMWH), 3) aspirin and 4) NOACs in this subgroup of patients.RESULTS: NOACs were as effective as uninterrupted warfarin in terms of bleeding complications and TE events. Surprisingly, the aspirin group had more hemorrhagic complications than both the warfarin and NOACs groups.CONCLUSION: In the current study, the use of NOACs was an effective and safe approach in CB ablation.

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KW - dabigatran

KW - heparin

KW - low molecular weight heparin

KW - rivaroxaban

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KW - ablation catheter

KW - ablation therapy

KW - absence of side effects

KW - adult

KW - aged

KW - article

KW - atrial fibrillation

KW - bleeding

KW - bleeding disorder

KW - cardiovascular disease assessment

KW - catheter

KW - catheter sheath

KW - CHA2DS2-VASc score

KW - comparative study

KW - continuous infusion

KW - controlled study

KW - coronary artery disease

KW - cryoablation

KW - drug efficacy

KW - drug safety

KW - dyslipidemia

KW - female

KW - groin hematoma

KW - HAS BLED score

KW - heart failure

KW - heart left atrium

KW - heart left ventricle ejection fraction

KW - heart tamponade

KW - human

KW - hypertension

KW - lung hemorrhage

KW - major clinical study

KW - male

KW - mapping catheter

KW - middle aged

KW - practice guideline

KW - pulmonary vein

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DO - 10.1016/j.hjc.2016.11.003

M3 - Article

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VL - 57

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JO - Hellenic Journal of Cardiology

JF - Hellenic Journal of Cardiology

SN - 1109-9666

IS - 5

ER -

The role of novel oral anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation

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Keywords

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