Dr. McElderry reports doing consulting, speaking and research for Biosense Webster, Boston Scientific, St. Jude Medical, VytronUS, and Voyage Medical. Other authors: No disclosures.
Dabigatran versus Warfarin Therapy for Uninterrupted Oral Anticoagulation During Atrial Fibrillation Ablation
Article first published online: 11 APR 2013
© 2013 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 24, Issue 8, pages 861–865, August 2013
How to Cite
MADDOX, W., KAY, G. N., YAMADA, T., OSORIO, J., DOPPALAPUDI, H., PLUMB, V. J., GUNTER, A. and MCELDERRY, H. T. (2013), Dabigatran versus Warfarin Therapy for Uninterrupted Oral Anticoagulation During Atrial Fibrillation Ablation. Journal of Cardiovascular Electrophysiology, 24: 861–865. doi: 10.1111/jce.12143
- Issue published online: 22 JUL 2013
- Article first published online: 11 APR 2013
- Accepted manuscript online: 15 MAR 2013 12:00PM EST
- Manuscript Accepted: 3 APR 2013
- Manuscript Revised: 27 FEB 2013
- Manuscript Received: 10 OCT 2012
- atrial fibrillation;
- catheter ablation;
Dabigatran versus Warfarin for AF Ablation
Uninterrupted oral anticoagulant (OA) therapy with warfarin has become the standard of care at many centers performing catheter ablation of atrial fibrillation (AF). Compared with warfarin, dabigatran, a direct thrombin inhibitor, has been demonstrated to reduce the risk of stroke in nonvalvular AF with similar bleeding risk. Few data exist on the safety profile of uninterrupted dabigatran therapy during AF ablation.
We compared the safety and efficacy of uninterrupted OA therapy with either warfarin or dabigatran in all patients undergoing AF catheter ablation at the University of Alabama at Birmingham between November 1, 2010 and January 31, 2012. All patients underwent a transesophageal echocardiogram (TEE) on the day of their ablation procedure to assess for the presence of intracardiac thrombi. All complications were identified and classified as bleeding, thromboembolic events, or other.
There were 212 patients in the dabigatran group and 251 patients in the warfarin group. The groups were well matched. There were 3 complications in the dabigatran group and 6 in the warfarin group (P = 0.45). There were 2 bleeding complications in the dabigatran group and 6 in the warfarin group (P = 0.23). There was one thromboembolic complication (a possible TIA) in the dabigatran group and none in the warfarin group (P = 0.28).
The administration of dabigatran is as safe and effective as warfarin for uninterrupted OA therapy during catheter ablation of AF.