Open AccessSafety and efficacy of DOACs vs acenocoumarol in patients undergoing catheter ablation of atrial fibrillation
Author(s) -
Vlachos Konstantinos,
Efremidis Michael,
Bazoukis George,
Letsas Konstantinos P.,
Saplaouras Athanasios,
Georgopoulos Stamatis,
Karamichalakis Nikolaos,
Rokiza Aikaterini,
Sakellaropoulou Antigoni,
Kolokathis Angelos Michail,
Efremidis Theodoros,
Asvestas Dimitrios,
Sideris Antonios
Publication year - 2017
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22734
Subject(s) - medicine , acenocoumarol , atrial fibrillation , pseudoaneurysm , surgery , hematoma , complication , pericardial effusion , cardiac tamponade , groin , anesthesia , warfarin
Background Thromboembolic complications can be life‐threatening during atrial fibrillation ( AF ) catheter ablation. The aim of our study was to evaluate the safety and efficacy of continuous treatment using direct oral anticoagulants ( DOACs ) as an alternative to uninterrupted acenocoumarol for periprocedural anticoagulation. Hypothesis Continuous treatment with DOACs has similar safety and efficacy compared to acenocoumarol. Methods We enrolled 474 patients (mean age, 58 years; 68.4% male) undergoing AF catheter ablation between June 2013 and December 2016. All patients were equally assigned to take acenocoumarol (group 1, 136 patients) or DOACs (group 2, 338 patients) for ≥2 months before the procedure. We compared thromboembolic and bleeding complications between the 2 groups. Results Our analysis showed no significant difference in major and minor complications between the 2 patient groups. Specifically, 3 of 136 patients (2.2%) using uninterrupted acenocoumarol had a major complication (1 patient [0.7%] had transient ischemic attack resolved 8 hours later, 1 [0.7%] had pericardial tamponade, and 1 [0.7%] had a subcapsular renal hematoma) and 2 patients (1.4%) had minor complications (1 [0.7%] pseudoaneurysm and 1 [0.7%] groin hematoma). In group 2, 1 of 338 patients (0.3%) had a major complication (transient ischemic attack). In the same group, 7 patients (2.1%) had a minor complication (1 patient [0.3%] presented with pseudoaneurysm, 4 [1.2%] with pericardial effusion <1 cm, 1 [0.3%] femoral arteriovenous fistula between the femoral artery and femoral vein, and 1 [0.7%] groin hematoma). Conclusions DOACs and acenocoumarol have similar safety and effectiveness regarding thromboembolic complications prevention without increasing bleeding complications.