Safety of catheter ablation of atrial fibrillation without pre- or peri-procedural imaging for the detection of left atrial thrombus in the era of uninterrupted anticoagulation.
atrial fibrillation
catheter ablation
left atrial thrombus
stroke
transesophageal echocardiography
Journal
Journal of arrhythmia
ISSN: 1880-4276
Titre abrégé: J Arrhythm
Pays: Japan
ID NLM: 101263026
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
04
08
2020
revised:
18
10
2020
accepted:
04
11
2020
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
6
3
2021
Statut:
epublish
Résumé
The need for pre- or peri-procedural imaging to rule out the presence of left atrial thrombus in patients undergoing catheter ablation of atrial fibrillation (AF) is unclear in the era of uninterrupted direct oral anticoagulant (DOAC) regimen. We sought to examine the safety of catheter ablation in appropriately selected patients with paroxysmal AF without performing screening for left atrial thrombus. Consecutive patients planned for radiofrequency AF catheter ablation between January 2016 and June 2020 were enrolled, and prospectively studied. All subjects were receiving uninterrupted anticoagulation with DOACs for at least 4 weeks before the procedure. All subjects were in sinus rhythm the day of the procedure. The primary outcome of the study was ischemic stroke or transient ischemic attack (TIA) during at 30 days. A total of 451 patients (age 59.7 ± 10.2 years, 289 males) with paroxysmal AF were included in the study. The mean CHA Catheter ablation can be safely performed in low-risk patients with paroxysmal AF without imaging for the detection of left atrial thrombus in the era of uninterrupted DOAC anticoagulation.
Sections du résumé
BACKGROUND
BACKGROUND
The need for pre- or peri-procedural imaging to rule out the presence of left atrial thrombus in patients undergoing catheter ablation of atrial fibrillation (AF) is unclear in the era of uninterrupted direct oral anticoagulant (DOAC) regimen. We sought to examine the safety of catheter ablation in appropriately selected patients with paroxysmal AF without performing screening for left atrial thrombus.
PATIENTS AND METHODS
METHODS
Consecutive patients planned for radiofrequency AF catheter ablation between January 2016 and June 2020 were enrolled, and prospectively studied. All subjects were receiving uninterrupted anticoagulation with DOACs for at least 4 weeks before the procedure. All subjects were in sinus rhythm the day of the procedure. The primary outcome of the study was ischemic stroke or transient ischemic attack (TIA) during at 30 days.
RESULTS
RESULTS
A total of 451 patients (age 59.7 ± 10.2 years, 289 males) with paroxysmal AF were included in the study. The mean CHA
CONCLUSIONS
CONCLUSIONS
Catheter ablation can be safely performed in low-risk patients with paroxysmal AF without imaging for the detection of left atrial thrombus in the era of uninterrupted DOAC anticoagulation.
Identifiants
pubmed: 33664883
doi: 10.1002/joa3.12466
pii: JOA312466
pmc: PMC7896446
doi:
Types de publication
Journal Article
Langues
eng
Pagination
28-32Informations de copyright
© 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Europace. 2010 Nov;12(11):1550-7
pubmed: 20716548
Heart Rhythm. 2020 Dec;17(12):2093-2099
pubmed: 32681991
N Engl J Med. 2017 Apr 27;376(17):1627-1636
pubmed: 28317415
Europace. 2011 Apr;13(4):486-91
pubmed: 21186230
Europace. 2010 Jul;12(7):927-32
pubmed: 20304842
Eur Heart J. 2015 Jul 21;36(28):1805-11
pubmed: 25975659
Europace. 2020 Jul 1;22(7):1026-1035
pubmed: 32142113
Echo Res Pract. 2017 Dec;4(4):45-52
pubmed: 28864464
Clin Res Cardiol. 2019 Feb;108(2):150-156
pubmed: 30051177
Anesthesiology. 2010 May;112(5):1084-96
pubmed: 20418689
Heart Rhythm. 2016 Jun;13(6):1197-202
pubmed: 26994940
J Cardiovasc Electrophysiol. 2019 Jan;30(1):47-57
pubmed: 30288830
Circulation. 2014 Jun 24;129(25):2638-44
pubmed: 24744272
JACC Clin Electrophysiol. 2017 Apr;3(4):329-336
pubmed: 29759444
Heart Rhythm. 2018 Jan;15(1):107-115
pubmed: 28917562
Europace. 2018 Jan 1;20(1):e1-e160
pubmed: 29016840