Τίτλος:
Oral anticoagulant therapy for stroke prevention in patients with atrial fibrillation undergoing ablation: Results from the First European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA)
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The European Snapshot Survey on Procedural Routines in Atrial Fibrillation Ablation (ESS-PRAFA) is a prospective, multicentre snapshot survey of patients undergoing atrial fibrillation (AF) ablation, conducted to collect patient-based data on current clinical practices in AF ablation in context of the latest AF Guidelines and contemporary oral anticoagulant therapies. The EP Research Network Centres were asked to prospectively enrol consecutive patients during a 6-week period (September/October 2014). Data were collected via the web-based case report form. We present the results pertinent to the use of antithrombotic therapies. Thirteen countries prospectively enrolled 455 eligible consecutive patients [mean age 59±10.8 years, 131 (28.8%) females]. The mean CHA2DS2-VASc score was 1.12±1.06 [137 patients (30.1%) had a score of ≥2]. Before ablation, 443 patients (97.4%) were on anticoagulant therapy [143 (31.4%) on non-vitamin K antagonist oral anticoagulants (NOACs) and 264 (58.0%) on vitamin K antagonists (VKAs)]. Of the latter, 79.7% underwent ablation without VKA interruption, whilst a variety of strategies were used in patients taking NOAC. After ablation, most patients (89.3%) continued the same anticoagulant as before, and 2 (0.4%) were not prescribed any anticoagulation. At discharge, 280 patients (62.2%) were advised oral anticoagulation for a limited period of mean 3.8±2.2 months. On multivariate analysis, CHA2DS2-VASc, AF duration, prior VKA use, and estimated AF ablation success were significantly associated with the decision on short-term anticoagulation. Our results show the increasing use of NOAC in patients undergoing AF ablation and emphasize the need for more information to guide the periprocedural use of both NOACs and VKAs in real-world setting. © The Author 2015. All rights reserved.
Συγγραφείς:
Potpara, T.S.
Larsen, T.B.
Deharo, J.C.
Rossvoll, O.
Dagres, N.
Todd, D.
Pison, L.
Proclemer, A.
Purefellner, H.
Blomström-Lundqvist, C.
Bongiorni, M.G.
Chen, J.
Estner, H.
Hernandez-Madrid, A.
Hocini, M.
Sciraffia, E.
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
acetylsalicylic acid; anticoagulant agent; antivitamin K; apixaban; dabigatran; heparin; low molecular weight heparin; rivaroxaban; anticoagulant agent, ablation therapy; adult; aged; anticoagulant therapy; atrial fibrillation; cerebrovascular accident; cha2ds2 vasc score; female; health survey; hospital discharge; human; major clinical study; male; middle aged; multicenter study; outcome assessment; priority journal; prospective study; Review; scoring system; treatment duration; treatment indication; atrial fibrillation; catheter ablation; clinical practice; clinical trial; cohort analysis; complication; Europe; oral drug administration; postoperative care; practice guideline; preoperative care; procedures; protocol compliance; statistics and numerical data; Stroke; treatment outcome; very elderly, Administration, Oral; Adult; Aged; Aged, 80 and over; Anticoagulants; Atrial Fibrillation; Catheter Ablation; Cohort Studies; Europe; Female; Guideline Adherence; Humans; Male; Middle Aged; Postoperative Care; Practice Guidelines as Topic; Practice Patterns, Physicians'; Preoperative Care; Prospective Studies; Stroke; Treatment Outcome
DOI:
10.1093/europace/euv132
