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Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry

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Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry. / Nührich, Jana Mareike; Kuck, Karl-Heinz; Andresen, Dietrich; Steven, Daniel; Spitzer, Stefan G; Hoffmann, Ellen; Schumacher, Burghard; Eckardt, Lars; Brachmann, Johannes; Lewalter, Thorsten; Hochadel, Matthias; Senges, Jochen; Willems, Stephan; Hoffmann, Boris A.

in: CLIN RES CARDIOL, Jahrgang 104, Nr. 6, 06.2015, S. 463-470.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Nührich, JM, Kuck, K-H, Andresen, D, Steven, D, Spitzer, SG, Hoffmann, E, Schumacher, B, Eckardt, L, Brachmann, J, Lewalter, T, Hochadel, M, Senges, J, Willems, S & Hoffmann, BA 2015, 'Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry', CLIN RES CARDIOL, Jg. 104, Nr. 6, S. 463-470. https://doi.org/10.1007/s00392-014-0804-1

APA

Nührich, J. M., Kuck, K-H., Andresen, D., Steven, D., Spitzer, S. G., Hoffmann, E., Schumacher, B., Eckardt, L., Brachmann, J., Lewalter, T., Hochadel, M., Senges, J., Willems, S., & Hoffmann, B. A. (2015). Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry. CLIN RES CARDIOL, 104(6), 463-470. https://doi.org/10.1007/s00392-014-0804-1

Vancouver

Nührich JM, Kuck K-H, Andresen D, Steven D, Spitzer SG, Hoffmann E et al. Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry. CLIN RES CARDIOL. 2015 Jun;104(6):463-470. https://doi.org/10.1007/s00392-014-0804-1

Bibtex

@article{666a1cf121df4de18d354cb2cfdfbf5d,
title = "Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry",
abstract = "AIMS: Atrial fibrillation (AF) is the most common cause of ischemic stroke. Recent data suggest that AF patients after successful ablation have the same risk for thromboembolic events (TE) as patients without AF. Despite current guideline recommendations it is still under debate if oral anticoagulation (OAC) can be safely discontinued after ablation. We analyzed follow-up (FU) after ablation of paroxysmal AF (PAF) in a high- (previous stroke; group 1) and a low-risk group (no previous stroke; group 2) based on data from the German Ablation Registry to reveal real-life prescription behavior.METHODS: Overall 29 centers in Germany participated by performing AF-ablation. Between April 2008 and April 2011, 83 patients in group 1 and 377 patients in group 2 with a first ablation of PAF were included in the registry.RESULTS: Mean CHA2DS2-VASc-Score was 4.2 ± 1.4 (group 1) vs. 1.6 ± 1.2 (group 2) (p < 0.0001). No peri-interventional TE was observed. Arrhythmia recurrence was seen in 47.4 vs. 48.4% (p = 0.79) during a median FU of 489 (453-782) days, resulting in a repeat procedure in 20.0 vs. 20.7% (p = 0.88), respectively. OAC was discontinued in 38.6% in group 1 vs. 66.3% in group 2 (p < 0.0001) during FU. TE during FU occurred more often in group 1 than in group 2 (4.3 vs. 0.3%, p < 0.05).CONCLUSION: Even in patients with previous stroke, OAC was frequently discontinued during FU after PAF ablation in this observational study. However, TE occurred significantly more frequent in these high-risk patients. These data argue against OAC discontinuation after ablation in patients with previous stroke.",
keywords = "Administration, Oral, Aged, Anticoagulants/administration & dosage, Atrial Fibrillation/complications, Catheter Ablation/methods, Female, Follow-Up Studies, Germany, Humans, Male, Middle Aged, Recurrence, Registries, Risk, Stroke/epidemiology, Thromboembolism/epidemiology",
author = "N{\"u}hrich, {Jana Mareike} and Karl-Heinz Kuck and Dietrich Andresen and Daniel Steven and Spitzer, {Stefan G} and Ellen Hoffmann and Burghard Schumacher and Lars Eckardt and Johannes Brachmann and Thorsten Lewalter and Matthias Hochadel and Jochen Senges and Stephan Willems and Hoffmann, {Boris A}",
year = "2015",
month = jun,
doi = "10.1007/s00392-014-0804-1",
language = "English",
volume = "104",
pages = "463--470",
journal = "CLIN RES CARDIOL",
issn = "1861-0684",
publisher = "D. Steinkopff-Verlag",
number = "6",

}

RIS

TY - JOUR

T1 - Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry

AU - Nührich, Jana Mareike

AU - Kuck, Karl-Heinz

AU - Andresen, Dietrich

AU - Steven, Daniel

AU - Spitzer, Stefan G

AU - Hoffmann, Ellen

AU - Schumacher, Burghard

AU - Eckardt, Lars

AU - Brachmann, Johannes

AU - Lewalter, Thorsten

AU - Hochadel, Matthias

AU - Senges, Jochen

AU - Willems, Stephan

AU - Hoffmann, Boris A

PY - 2015/6

Y1 - 2015/6

N2 - AIMS: Atrial fibrillation (AF) is the most common cause of ischemic stroke. Recent data suggest that AF patients after successful ablation have the same risk for thromboembolic events (TE) as patients without AF. Despite current guideline recommendations it is still under debate if oral anticoagulation (OAC) can be safely discontinued after ablation. We analyzed follow-up (FU) after ablation of paroxysmal AF (PAF) in a high- (previous stroke; group 1) and a low-risk group (no previous stroke; group 2) based on data from the German Ablation Registry to reveal real-life prescription behavior.METHODS: Overall 29 centers in Germany participated by performing AF-ablation. Between April 2008 and April 2011, 83 patients in group 1 and 377 patients in group 2 with a first ablation of PAF were included in the registry.RESULTS: Mean CHA2DS2-VASc-Score was 4.2 ± 1.4 (group 1) vs. 1.6 ± 1.2 (group 2) (p < 0.0001). No peri-interventional TE was observed. Arrhythmia recurrence was seen in 47.4 vs. 48.4% (p = 0.79) during a median FU of 489 (453-782) days, resulting in a repeat procedure in 20.0 vs. 20.7% (p = 0.88), respectively. OAC was discontinued in 38.6% in group 1 vs. 66.3% in group 2 (p < 0.0001) during FU. TE during FU occurred more often in group 1 than in group 2 (4.3 vs. 0.3%, p < 0.05).CONCLUSION: Even in patients with previous stroke, OAC was frequently discontinued during FU after PAF ablation in this observational study. However, TE occurred significantly more frequent in these high-risk patients. These data argue against OAC discontinuation after ablation in patients with previous stroke.

AB - AIMS: Atrial fibrillation (AF) is the most common cause of ischemic stroke. Recent data suggest that AF patients after successful ablation have the same risk for thromboembolic events (TE) as patients without AF. Despite current guideline recommendations it is still under debate if oral anticoagulation (OAC) can be safely discontinued after ablation. We analyzed follow-up (FU) after ablation of paroxysmal AF (PAF) in a high- (previous stroke; group 1) and a low-risk group (no previous stroke; group 2) based on data from the German Ablation Registry to reveal real-life prescription behavior.METHODS: Overall 29 centers in Germany participated by performing AF-ablation. Between April 2008 and April 2011, 83 patients in group 1 and 377 patients in group 2 with a first ablation of PAF were included in the registry.RESULTS: Mean CHA2DS2-VASc-Score was 4.2 ± 1.4 (group 1) vs. 1.6 ± 1.2 (group 2) (p < 0.0001). No peri-interventional TE was observed. Arrhythmia recurrence was seen in 47.4 vs. 48.4% (p = 0.79) during a median FU of 489 (453-782) days, resulting in a repeat procedure in 20.0 vs. 20.7% (p = 0.88), respectively. OAC was discontinued in 38.6% in group 1 vs. 66.3% in group 2 (p < 0.0001) during FU. TE during FU occurred more often in group 1 than in group 2 (4.3 vs. 0.3%, p < 0.05).CONCLUSION: Even in patients with previous stroke, OAC was frequently discontinued during FU after PAF ablation in this observational study. However, TE occurred significantly more frequent in these high-risk patients. These data argue against OAC discontinuation after ablation in patients with previous stroke.

KW - Administration, Oral

KW - Aged

KW - Anticoagulants/administration & dosage

KW - Atrial Fibrillation/complications

KW - Catheter Ablation/methods

KW - Female

KW - Follow-Up Studies

KW - Germany

KW - Humans

KW - Male

KW - Middle Aged

KW - Recurrence

KW - Registries

KW - Risk

KW - Stroke/epidemiology

KW - Thromboembolism/epidemiology

U2 - 10.1007/s00392-014-0804-1

DO - 10.1007/s00392-014-0804-1

M3 - SCORING: Journal article

C2 - 25537233

VL - 104

SP - 463

EP - 470

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 6

ER -