Regional differences in patient characteristics and outcomes during uninterrupted anticoagulation with dabigatran versus warfarin in catheter ablation of atrial fibrillation: the RE-CIRCUIT study
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Regional differences in patient characteristics and outcomes during uninterrupted anticoagulation with dabigatran versus warfarin in catheter ablation of atrial fibrillation: the RE-CIRCUIT study. / Hohnloser, Stefan H; Calkins, Hugh; Willems, Stephan; Verma, Atul; Schilling, Richard; Okumura, Ken; Nordaby, Matias; Kleine, Eva; Biss, Branislav; Gerstenfeld, Edward P; RE-CIRCUIT Investigators.
In: J INTERV CARD ELECTR, Vol. 55, No. 2, 08.2019, p. 145-152.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Regional differences in patient characteristics and outcomes during uninterrupted anticoagulation with dabigatran versus warfarin in catheter ablation of atrial fibrillation: the RE-CIRCUIT study
AU - Hohnloser, Stefan H
AU - Calkins, Hugh
AU - Willems, Stephan
AU - Verma, Atul
AU - Schilling, Richard
AU - Okumura, Ken
AU - Nordaby, Matias
AU - Kleine, Eva
AU - Biss, Branislav
AU - Gerstenfeld, Edward P
AU - RE-CIRCUIT Investigators
PY - 2019/8
Y1 - 2019/8
N2 - PURPOSE: To describe regional differences in patient characteristics, ablation procedures, and bleeding events in the RE-CIRCUIT study. RE-CIRCUIT was a prospective, multicenter study that captured data from different regions, providing an opportunity to understand the practices followed in various regions. The incidence of major bleeding events (MBEs) was significantly lower with uninterrupted dabigatran versus uninterrupted warfarin.METHODS: Patients were randomized to receive dabigatran 150 mg twice daily or warfarin. Ablation was performed with uninterrupted anticoagulation for 8 weeks after the procedure. Regions were Western Europe, Eastern Europe, North America, and Asia.RESULTS: Of 704 patients screened across 104 sites, 635 underwent catheter ablation (dabigatran, 317; warfarin, 318). Patient characteristics were different across various regions. Patients from North America had the highest prevalence of atrial flutter (33%), coronary artery disease (29%), diabetes mellitus (18%), and previous myocardial infarction (9%). Hypertension was most prevalent in Eastern Europe (75%), as was congestive heart failure (40% vs 2% in Western Europe). Pulmonary vein isolation alone was the preferred technique used in most patients (86% in North America and 75-83% elsewhere) and radio frequency was the preferred energy source. The major outcome measure, incidence of MBEs during and up to 2 months after the procedure, was consistently lower with uninterrupted dabigatran versus warfarin, irrespective of regions and their procedural differences, and different ablation techniques utilized.CONCLUSIONS: This analysis shows that the benefits of dabigatran over a vitamin K antagonist in patients undergoing atrial fibrillation ablation are consistent across all geographic regions studied.TRIAL REGISTRATION: NCT02348723 (https://clinicaltrials.gov/ct2/show/NCT02348723).
AB - PURPOSE: To describe regional differences in patient characteristics, ablation procedures, and bleeding events in the RE-CIRCUIT study. RE-CIRCUIT was a prospective, multicenter study that captured data from different regions, providing an opportunity to understand the practices followed in various regions. The incidence of major bleeding events (MBEs) was significantly lower with uninterrupted dabigatran versus uninterrupted warfarin.METHODS: Patients were randomized to receive dabigatran 150 mg twice daily or warfarin. Ablation was performed with uninterrupted anticoagulation for 8 weeks after the procedure. Regions were Western Europe, Eastern Europe, North America, and Asia.RESULTS: Of 704 patients screened across 104 sites, 635 underwent catheter ablation (dabigatran, 317; warfarin, 318). Patient characteristics were different across various regions. Patients from North America had the highest prevalence of atrial flutter (33%), coronary artery disease (29%), diabetes mellitus (18%), and previous myocardial infarction (9%). Hypertension was most prevalent in Eastern Europe (75%), as was congestive heart failure (40% vs 2% in Western Europe). Pulmonary vein isolation alone was the preferred technique used in most patients (86% in North America and 75-83% elsewhere) and radio frequency was the preferred energy source. The major outcome measure, incidence of MBEs during and up to 2 months after the procedure, was consistently lower with uninterrupted dabigatran versus warfarin, irrespective of regions and their procedural differences, and different ablation techniques utilized.CONCLUSIONS: This analysis shows that the benefits of dabigatran over a vitamin K antagonist in patients undergoing atrial fibrillation ablation are consistent across all geographic regions studied.TRIAL REGISTRATION: NCT02348723 (https://clinicaltrials.gov/ct2/show/NCT02348723).
KW - Aged
KW - Anticoagulants/administration & dosage
KW - Asia
KW - Atrial Fibrillation/surgery
KW - Catheter Ablation/methods
KW - Comorbidity
KW - Dabigatran/administration & dosage
KW - Europe
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - North America
KW - Prospective Studies
KW - Warfarin/administration & dosage
U2 - 10.1007/s10840-019-00518-x
DO - 10.1007/s10840-019-00518-x
M3 - SCORING: Journal article
C2 - 30758702
VL - 55
SP - 145
EP - 152
JO - J INTERV CARD ELECTR
JF - J INTERV CARD ELECTR
SN - 1383-875X
IS - 2
ER -