SAFETY OF UNINTERRUPTED VERSUS INTERRUPTED ANTICOAGULATION AROUND CATHETER ABLATION (AF-UNITE) N. Wayne, O. Kamneva, S. Baumhover, D. Liang, J. Toler, J. Peak Rex Hospital - Raleigh, NC
Background/Purpose: Evaluate if an uninterrupted anticoagulation strategy with direct oral anticoagulants (DOAC) is associated with less bleeding and thromboembolic complications when compared to an interrupted anticoagulation strategy with DOACs in patients undergoing catheter ablation for atrial fibrillation or atrial flutter.
Methodology: This single-center, retrospective study included adult patients who underwent catheter ablation between 06/2014 and 06/2017 and were anticoagulated with a DOAC. The uninterrupted anticoagulation group, with the last dose of DOAC taken within 36 hours of catheter ablation, was compared to the interrupted anticoagulation group, with the last dose of DOAC taken greater than or equal to 36 hours of catheter ablation. Patients with pregnancy, dialysis, valvular atrial fibrillation, and no anticoagulation with a DOAC pre- and post-ablation were excluded. The primary endpoint was the proportion of patients with a bleeding complication up to 90 days post-ablation procedure. The secondary endpoint was the proportion of patients with a thromboembolic event up to 90 days post-ablation procedure.
Results: A total of 113 patients (n=80 interrupted group, n=33 uninterrupted group) were analyzed. There were no differences in the primary (4% interrupted vs. 0% uninterrupted; p=0.5546) or the secondary endpoints (1% interrupted vs. 0% uninterrupted; p=1) in the study. Baseline characteristics were similar across the groups with the exception of length of stay, which was longer in the interrupted arm (2.48 days interrupted vs. 1.39 days uninterrupted; p=0.0005).
Conclusions: Although not statistically significant, in patients undergoing catheter ablation for atrial fibrillation or atrial flutter an uninterrupted anticoagulation strategy with DOACs may be associated with less bleeding and thromboembolic complications within 90 days post-ablation.
Presentation Objective: Discuss the safety and efficacy of uninterrupted and interrupted anticoagulation strategies around catheter ablation.
Self-Assessment: Which factors may impact the decision to interrupt anticoagulation around catheter ablation?
