Ablation of Atrial Fibrillation Without Left Atrial Appendage Imaging in Patients Treated With Direct Oral Anticoagulants.
Aged
Atrial Appendage
/ diagnostic imaging
Atrial Fibrillation
/ diagnostic imaging
Atrial Flutter
/ diagnostic imaging
Catheter Ablation
/ adverse effects
Databases, Factual
Echocardiography, Transesophageal
Factor Xa Inhibitors
/ adverse effects
Feasibility Studies
Female
Hemorrhage
/ chemically induced
Humans
Male
Middle Aged
Ohio
Prospective Studies
Pulmonary Veins
/ physiopathology
Registries
Risk Assessment
Risk Factors
Stroke
/ prevention & control
Thromboembolism
/ prevention & control
Treatment Outcome
Unnecessary Procedures
atrial fibrillation
atrial flutter
echocardiography
stroke
Journal
Circulation. Arrhythmia and electrophysiology
ISSN: 1941-3084
Titre abrégé: Circ Arrhythm Electrophysiol
Pays: United States
ID NLM: 101474365
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
pubmed:
25
7
2020
medline:
16
3
2021
entrez:
25
7
2020
Statut:
ppublish
Résumé
Many centers continue to routinely perform transesophageal echocardiograms before atrial fibrillation (AF) ablation procedures in patients treated with direct oral anticoagulants (DOACs). One study suggested that the procedures could be done without transesophageal echocardiogram but used intracardiac echocardiography imaging of the appendage from the right ventricular outflow. This study aimed to assess the safety of ablation for AF without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage in DOAC compliant patients. All patients undergoing AF ablation at the Cleveland Clinic (2011-2018) were enrolled in a prospectively maintained data registry. All consecutive patients presenting with AF or atrial flutter on DOAC were included. Periprocedural thromboembolic complications were assessed. A total of 900 patients were included. Their median CHA In DOAC compliant patients who present for ablation in AF/atrial flutter, the procedures could be performed without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage; with low risk of complications.
Sections du résumé
BACKGROUND
Many centers continue to routinely perform transesophageal echocardiograms before atrial fibrillation (AF) ablation procedures in patients treated with direct oral anticoagulants (DOACs). One study suggested that the procedures could be done without transesophageal echocardiogram but used intracardiac echocardiography imaging of the appendage from the right ventricular outflow. This study aimed to assess the safety of ablation for AF without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage in DOAC compliant patients.
METHODS
All patients undergoing AF ablation at the Cleveland Clinic (2011-2018) were enrolled in a prospectively maintained data registry. All consecutive patients presenting with AF or atrial flutter on DOAC were included. Periprocedural thromboembolic complications were assessed.
RESULTS
A total of 900 patients were included. Their median CHA
CONCLUSIONS
In DOAC compliant patients who present for ablation in AF/atrial flutter, the procedures could be performed without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage; with low risk of complications.
Identifiants
pubmed: 32706992
doi: 10.1161/CIRCEP.119.008301
doi:
Substances chimiques
Factor Xa Inhibitors
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM