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The use of dabigatran immediately after atrial fibrillation ablation
Journal of Cardiovascular Electrophysiology, 01/19/2012
Clinical Article
Winkle RA et al. – Dabigatran is safe and well tolerated after atrial fibrillation (AF) ablation. It did not cause bleeding complications and there were no thromboembolic events. Dabigatran appears to be an alternative to warfarin after AF ablation.
Methods- Authors evaluated 123 consecutive patients who were started on dabigatran after AF ablation.
- Patients were given enoxaparin 0.5 mg/kg at the end of the procedure, which was repeated 12 hours later and then discontinued.
- Dabigatran was started 22 hours postablation with drug dose based on renal function.
- Primary outcomes were thromboembolic events, bleeding complications, and side effects over a 30–day follow–up period.
- The preablation anticoagulant was warfarin in 56 (45.5%) patients, dabigatran in 34 (27.6%), and aspirin in 26 (21.1%).
- Seven (5.7%) patients were on no anticoagulant before ablation.
- The patients on dabigatran before ablation with normal renal function had the drug stopped 36 hours preablation.
- There were no preprocedural or intraprocedural thromboembolic episodes or bleeding.
- Three patients received dabigatran 75 mg bid and the rest 150 mg bid.
- There were no postablation strokes, transient ischemic attacks, or systemic thromboemboli in any patient.
- Three patients discontinued dabigatran and were changed to warfarin, 2 because of gastrointestinal side effects and 1 because of a diffuse rash.