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Journal of Interventional Cardiac Electrophysiology
Erschienen in: Journal of Interventional Cardiac Electrophysiology 3/2016

28.03.2016

Impact of periprocedural anticoagulation strategy on the incidence of new-onset silent cerebral events after radiofrequency catheter ablation of atrial fibrillation

verfasst von: Patrick Müller, Philipp Halbfass, Attila Szöllösi, Johannes-Wolfgang Dietrich, Franziska Fochler, Karin Nentwich, Markus Roos, Joachim Krug, Rainer Schmitt, Andreas Mügge, Thomas Deneke

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 3/2016

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Abstract

Background

Silent cerebral events (SCEs) have been observed on diffusion-weighted cerebral magnetic resonance imaging (MRI) in a substantial number of asymptomatic patients after atrial fibrillation (AF) ablation procedures. The purpose of this study was to investigate if periprocedural oral anticoagulation (OAC) management affects the incidence of new-onset SCE after radiofrequency catheter ablation (RFCA) of AF.

Methods and results

One hundred ninety-two consecutive patients (64 ± 10.1 years, 38.5 % women) with symptomatic paroxysmal (n = 80, 41.7 %) or persistent AF undergoing RFCA of AF were prospectively enrolled. Periprocedural anticoagulation strategies were defined as uninterrupted use of novel oral anticoagulants (NOACs) (group I, n = 64), interrupted use of NOACs (group II, n = 42), continuation of vitamin K antagonist (VKA) with an international normalized ratio (INR) between 2.0 and 3.0 (group III, n = 43), and VKA discontinuation bridged with low molecular weight heparin (group IV, n = 43). Cerebral MRI was performed 1 to 2 days after RFCA for detection of new SCE. Overall, new SCEs were detected in 41 patients (21.4 %) after AF ablation. New SCEs were detected in 12.5 % in group I, 35.7 % in group II, 18.6 % in group III, and 23.3 % in group IV (p < 0.05). Multivariable logistic regression analysis revealed persistent AF and discontinuation of periprocedural OAC (group II and IV) to be independent predictors for the development of SCE. No relevant complications were identified.

Conclusions

Periprocedural continuation of NOAC as well as continuation of VKA seems to be safe and significantly reduce the occurrence of SCE after AF ablation.
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Metadaten
Titel
Impact of periprocedural anticoagulation strategy on the incidence of new-onset silent cerebral events after radiofrequency catheter ablation of atrial fibrillation
verfasst von
Patrick Müller
Philipp Halbfass
Attila Szöllösi
Johannes-Wolfgang Dietrich
Franziska Fochler
Karin Nentwich
Markus Roos
Joachim Krug
Rainer Schmitt
Andreas Mügge
Thomas Deneke
Publikationsdatum
28.03.2016
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 3/2016
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-016-0117-6

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