Oral anticoagulant use around the time of atrial fibrillation ablation: a review of the current evidence of individual oral anticoagulant use for periprocedural atrial fibrillation ablation thromboembolic prophylaxis

J Cardiovasc Electrophysiol. 2014 Dec;25(12):1411-8. doi: 10.1111/jce.12546. Epub 2014 Oct 10.

Abstract

Atrial fibrillation is the most common arrhythmia and ablation is becoming more prevalent as a treatment option. Appropriate treatment of atrial fibrillation mandates thromboembolic prophylaxis, and atrial fibrillation ablation periprocedural management of oral anticoagulation is paramount because of the unique susceptibility for thromboembolism that exists for a patient undergoing ablation. Uninterrupted warfarin therapy is the current standard approach for periprocedural atrial fibrillation anticoagulation. Novel oral anticoagulants, including direct thrombin and factor Xa inhibitors, are being used more frequently for thromboembolic prophylaxis in atrial fibrillation patients, but the best strategy for using novel oral anticoagulants in periprocedural anticoagulation is unknown. Optimal periprocedural anticoagulation management strategies with oral anticoagulants, limitations of using novel oral anticoagulants, and future directions in this field are discussed.

Keywords: atrial fibrillation; atrial fibrillation ablation; novel oral anticoagulants; thromboembolic prophylaxis.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / administration & dosage*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / adverse effects*
  • Catheter Ablation / methods
  • Evidence-Based Medicine
  • Humans
  • Premedication / methods*
  • Thromboembolism / etiology*
  • Thromboembolism / prevention & control*
  • Treatment Outcome

Substances

  • Anticoagulants