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유희태
유희태 (Hee Tae Yu) 저자 이메일 보기
연세대학교 의과대학
 
조회 257  인쇄하기 주소복사 트위터 공유 페이스북 공유 
When is it appropriate to stop non-vitamin K antagonist oral anticoagulants before catheter ablation of atrial fibrillation? A multicentre prospective randomized study
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Abstract

Aims
Although a recent expert consensus statement has recommended periprocedural uninterrupted (UI) non-vitamin K antagonist oral anticoagulants (NOACs) during catheter ablation of atrial fibrillation (AF) as a Class I indication, there have been no clear randomized trials. We investigated the safety and efficacy of UI, procedure day single-dose skipped (SDS), and 24-hour skipped (24S) NOACs in patients undergoing AF ablation.

Methods and results
In this prospective, open-label, randomized multicentre trial, 326 patients (75% male, 58 ± 11 years old) scheduled for AF catheter ablation were randomly assigned in a 1:1:1 ratio to UI, SDS, and 24S at three tertiary hospitals. Bridging with low molecular weight heparin was carried out in the patients with persistent AF who were assigned to the 24S group. Dabigatran, rivaroxaban, and apixaban were assigned in order after randomization. The primary endpoint was the incidence of bleeding events within 1 month after ablation. The secondary endpoints included thrombo-embolic and other procedure-related complications. The intra-procedural heparin requirement was higher in the 24S group than others (P < 0.001), and the mean activated clotting time was comparable among the groups (P = 0.139). The incidence of major bleeding up to 1 month after ablation and a post-procedural reduction in the haemoglobin levels did not significantly differ among the treatment groups and different NOACs (P > 0.05). There were no fatal events or thrombo-embolic complications in all the three groups.

Conclusion
In patients undergoing AF ablation, UI NOACs and SDS or double dose skipped NOACs had a comparable efficacy and safety, regardless of the type of NOAC.

Keywords : Atrial fibrillation, Catheter ablation, Non-vitamin K antagonist oral anticoagulant, Bleeding

논문정보
- 형식: Research article
- 게재일: 2018년 12월 (BRIC 등록일 2019-01-04)
- 연구진: 국내연구진태극기
- 분야: Medicine
골수 줄기세포에서 전환분화한 표피세포와 피부 줄기세포의 피부암 및 궤양 발달의 역할과 기작[Nat. Commun.]
박희준
발표: 박희준 (Fred Hutchinson Cancer Research Cen...)
일자: 2019년 1월 22일 (화) 오전 10시 (한국시간)
언어: 한국어
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