| Backgrounds:Prevention of thromboembolism is very important in patients with AF undergoing RFCA. The ideal method of anticoagulating a patient pre, intra or post ablation has always been a subject of hot research and discussion.Objective:To compare the safety and efficacy of dabigatran with warfarin for periprocedural anticoagulation in patients undergoing atrial fibrillation ablation.Methods:This study compared two stroke prevention strategies including warfarin and dabigatran in periprocedural anticoagulation of patients with AF undergoing RFCA. Warfarin was administered with a therapeutic INR of 2-3 and interrupted 5-7 days before the procedure substituted with low molecular weight heparin in Group 1. Patients were administered dabigatran 110mg po bid for at least 3 days before the procedure which was stopped 12 hours pre-procedure.Results:This study contained total 137 patients (54 patients in warfarin group,83 patients in dabigatran group). There was no significant difference in the presence of LAA thrombus between warfarin group and dabigatran group (5.6%,0%, p=0.06). There was one patient occurred TIA after the procedure in warfarin group (1.9%), no patients with stroke or TIA were found in the dabigatran group (p=0.39). There were no cardiac tamponade events in the two groups. There was no significant difference in mild pericardial effusion between the two groups (0%,6.0%, p=0.07%), and there was also no significant difference in groin hematoma between the two groups (1.9%,0%, P=0.39%). There were no major bleeding events including severe gastrointestinal hemorrhage and intracranial hemorrhage in the two groups, but dabigatran group had a higher risk of mirror bleeding including ecchymoses, gingival hemorrhage and fecal occult blood positive than wafarin group (15.7%,3.7%, p=0.047).Conclusion:The results suggest that dabigatran is safe and efficient in periprocedural anticoagulation of AF patients undergoing RFCA. |
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