One-Year Course of Periprocedural Anticoagulation in Atrial Fibrillation Ablation: Results of a German Nationwide Survey
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One-Year Course of Periprocedural Anticoagulation in Atrial Fibrillation Ablation: Results of a German Nationwide Survey. / Bejinariu, Alexandru Gabriel; Makimoto, Hisaki; Wakili, Reza; Mathew, Shibu; Kosiuk, Jedrzej; Linz, Dominik; Steinfurt, Johannes; Dechering, Dirk G; Meyer, Christian; Veltmann, Christian; Kelm, Malte; Frommeyer, Gerrit; Eckardt, Lars; Deneke, Thomas; Duncker, David; Müller, Patrick.
in: CARDIOLOGY, Jahrgang 145, Nr. 10, 01.10.2020, S. 676-681.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - One-Year Course of Periprocedural Anticoagulation in Atrial Fibrillation Ablation: Results of a German Nationwide Survey
AU - Bejinariu, Alexandru Gabriel
AU - Makimoto, Hisaki
AU - Wakili, Reza
AU - Mathew, Shibu
AU - Kosiuk, Jedrzej
AU - Linz, Dominik
AU - Steinfurt, Johannes
AU - Dechering, Dirk G
AU - Meyer, Christian
AU - Veltmann, Christian
AU - Kelm, Malte
AU - Frommeyer, Gerrit
AU - Eckardt, Lars
AU - Deneke, Thomas
AU - Duncker, David
AU - Müller, Patrick
N1 - © 2020 The Author(s) Published by S. Karger AG, Basel.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - INTRODUCTION: Periprocedural oral anticoagulation (OAC) strategies for atrial fibrillation (AF) ablation procedures are changing rapidly.OBJECTIVE: To assess the management and course of periprocedural OAC for AF ablation procedures in experienced electrophysiology (EP) centers in Germany over the last 12 months.METHODS: The data are based on an electronic questionnaire, which was sent to 35 experienced EP centers in September 2018 and then exactly 1 year later. Participants provided information on their periprocedural OAC management, the handling with dual therapy (OAC plus single antiplatelet therapy), the availability of specific antidotes, the transseptal puncture approach, and noteworthy complications.RESULTS: Responses were received from all 35 centers and represent 10,010 AF ablation procedures annually. In 2018, the administration of vitamin K antagonist (VKA) was continued throughout the procedure at all centers (100%). In contrast, the majority of centers used minimally interrupted periprocedural non-vitamin K antagonist oral anticoagulants (NOAC) (54.3%), 13 centers (37.2%) completely interrupted NOAC, and only 3 centers (8.5%) continued NOAC throughout the procedure. At the 1-year follow-up survey, 32 centers were found to have continued their previous strategy of periprocedural OAC and 3 changed from a minimally interrupted to a continued NOAC strategy. Of note, 30 centers (85.7%) performed transseptal puncture fluoroscopically without additional cardiac imaging. In the setting of uninterrupted periprocedural OAC management, no relevant complications were noted.CONCLUSION: Our survey shows marked heterogeneous periprocedural OAC management at experienced EP centers in Germany. Whereas continuation of VKA has already been integrated into clinical practice, the majority of centers still use a minimally interrupted NOAC strategy.
AB - INTRODUCTION: Periprocedural oral anticoagulation (OAC) strategies for atrial fibrillation (AF) ablation procedures are changing rapidly.OBJECTIVE: To assess the management and course of periprocedural OAC for AF ablation procedures in experienced electrophysiology (EP) centers in Germany over the last 12 months.METHODS: The data are based on an electronic questionnaire, which was sent to 35 experienced EP centers in September 2018 and then exactly 1 year later. Participants provided information on their periprocedural OAC management, the handling with dual therapy (OAC plus single antiplatelet therapy), the availability of specific antidotes, the transseptal puncture approach, and noteworthy complications.RESULTS: Responses were received from all 35 centers and represent 10,010 AF ablation procedures annually. In 2018, the administration of vitamin K antagonist (VKA) was continued throughout the procedure at all centers (100%). In contrast, the majority of centers used minimally interrupted periprocedural non-vitamin K antagonist oral anticoagulants (NOAC) (54.3%), 13 centers (37.2%) completely interrupted NOAC, and only 3 centers (8.5%) continued NOAC throughout the procedure. At the 1-year follow-up survey, 32 centers were found to have continued their previous strategy of periprocedural OAC and 3 changed from a minimally interrupted to a continued NOAC strategy. Of note, 30 centers (85.7%) performed transseptal puncture fluoroscopically without additional cardiac imaging. In the setting of uninterrupted periprocedural OAC management, no relevant complications were noted.CONCLUSION: Our survey shows marked heterogeneous periprocedural OAC management at experienced EP centers in Germany. Whereas continuation of VKA has already been integrated into clinical practice, the majority of centers still use a minimally interrupted NOAC strategy.
KW - Administration, Oral
KW - Anticoagulants/therapeutic use
KW - Atrial Fibrillation/drug therapy
KW - Catheter Ablation
KW - Germany
KW - Heparin, Low-Molecular-Weight
KW - Humans
KW - Stroke/drug therapy
KW - Surveys and Questionnaires
U2 - 10.1159/000509399
DO - 10.1159/000509399
M3 - SCORING: Journal article
C2 - 32854099
VL - 145
SP - 676
EP - 681
JO - CARDIOLOGY
JF - CARDIOLOGY
SN - 0008-6312
IS - 10
ER -