Real-world investigation on discontinuation of oral anticoagulation after paroxysmal atrial fibrillation catheter ablation in China.
Oral anticoagulation
catheter ablation
paroxysmal atrial fibrillation
Journal
Annals of palliative medicine
ISSN: 2224-5839
Titre abrégé: Ann Palliat Med
Pays: China
ID NLM: 101585484
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
10
02
2020
accepted:
07
03
2020
pubmed:
22
5
2020
medline:
25
2
2021
entrez:
22
5
2020
Statut:
ppublish
Résumé
To find out the real-world investigation on discontinuation of oral anticoagulation after paroxysmal atrial fibrillation (AF) catheter ablation China. We enrolled in our study 1,508 consecutive paroxysmal AF patients who underwent catheter ablation from five centers. Patients' clinical data and follow-up data were collected. Clinical data included on-admission characteristics such as gender, age, type and duration of AF, type of ablation, ablation sessions, history of diseases, CHA2DS2-VASc score, echocardiographic variables, medication, and blood test variables. Follow-up data included duration of follow-up, the status of oral anticoagulant (OAC) therapy, adverse events, and recurrence of AF. A total of 1,491 patients were included in the final analysis, while the other 17 patients lost contact. The follow-up duration was 12 to 74 months (27.8±14.6 months). Of 1,491 patients, 989 (66.3%) patients stopped OAC therapy 3 to 14 months after successful ablation during follow-up. Stroke or transient ischemic attack (TIA) occurred in 37 (2.5%) patients. Major bleeding occurred in 24 (1.6%) patients. Six (0.4%) patients died at follow-up. Patients who stopped OAC had lower CHA2DS2-VASc score (1.5±1.4 vs. 2.4±1.7, P<0.05) and lower incidence of major bleeding (11/989 vs. 13/502, P<0.05). Of 989 patients who stopped OAC, 318 stopped according to doctor's prescription, and 671 stopped on their own decision. In patients who underwent brain MRI, patients who stopped OAC had a lower incidence of silent cerebral infarction (SCI) (37/904 vs. 38/419, P<0.05). Among patients who did not stop warfarin therapy, there were 117 (117/397, 29.5%) patients had not to achieve target INR. The incidence of adverse events was relatively low in paroxysmal AF patients who stopped OAC. The patient partly determined when OAC was discontinued. Target INR was not achieved in many patients who had not to stop OAC.
Sections du résumé
BACKGROUND
BACKGROUND
To find out the real-world investigation on discontinuation of oral anticoagulation after paroxysmal atrial fibrillation (AF) catheter ablation China.
METHODS
METHODS
We enrolled in our study 1,508 consecutive paroxysmal AF patients who underwent catheter ablation from five centers. Patients' clinical data and follow-up data were collected. Clinical data included on-admission characteristics such as gender, age, type and duration of AF, type of ablation, ablation sessions, history of diseases, CHA2DS2-VASc score, echocardiographic variables, medication, and blood test variables. Follow-up data included duration of follow-up, the status of oral anticoagulant (OAC) therapy, adverse events, and recurrence of AF.
RESULTS
RESULTS
A total of 1,491 patients were included in the final analysis, while the other 17 patients lost contact. The follow-up duration was 12 to 74 months (27.8±14.6 months). Of 1,491 patients, 989 (66.3%) patients stopped OAC therapy 3 to 14 months after successful ablation during follow-up. Stroke or transient ischemic attack (TIA) occurred in 37 (2.5%) patients. Major bleeding occurred in 24 (1.6%) patients. Six (0.4%) patients died at follow-up. Patients who stopped OAC had lower CHA2DS2-VASc score (1.5±1.4 vs. 2.4±1.7, P<0.05) and lower incidence of major bleeding (11/989 vs. 13/502, P<0.05). Of 989 patients who stopped OAC, 318 stopped according to doctor's prescription, and 671 stopped on their own decision. In patients who underwent brain MRI, patients who stopped OAC had a lower incidence of silent cerebral infarction (SCI) (37/904 vs. 38/419, P<0.05). Among patients who did not stop warfarin therapy, there were 117 (117/397, 29.5%) patients had not to achieve target INR.
CONCLUSIONS
CONCLUSIONS
The incidence of adverse events was relatively low in paroxysmal AF patients who stopped OAC. The patient partly determined when OAC was discontinued. Target INR was not achieved in many patients who had not to stop OAC.
Identifiants
pubmed: 32434352
pii: apm-20-565
doi: 10.21037/apm-20-565
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM