Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation
Qian XIN1
Chuang ZHANG1
Yu-Jia WANG1
Jian LI1
Tao CHEN1
Shi-Xing LI1
Wei WANG1
Yu YANG1
Wen-Juan SONG1
Jin ZHOU2
Xiang-Min SHI1
1.Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China2.Department of Health Service,the Eighth Medical Centre,Chinese PLA General Hospital,Beijing,China
摘要：BACKGROUND Uninterrupted use of oral anticoagulants before atrial fibrillation (AF) ablation can reduce the incidence of perioperative thromboembolic events. However, the effect of new oral anticoagulants on activated clotting time (ACT) in respo-nse to heparin during AF ablation in Chinese populations remains unknown. The aim of the present retrospective study was to investigate the value of ACTs in response to intraoperative heparin administration in patients using dabigatran or rivaroxaban.METHODS From January 2018 to December 2021, a total of 173 patients undergoing AF ablation were included in the study, in which 101 patients were treated with dabigatran, 72 patients were treated with rivaroxaban. The intraoperative ACT values were examined in both groups. The incidence of periprocedural complications was evaluated. RESULTS Initial heparin dosage (88 ± 19 U/kg vs. 78 ± 27 U/kg, P < 0.05), total heparin dosage (137 ± 41 U/kg vs. 106 ± 52 U/kg, P < 0.05) during the ablation procedure were higher in the dabigatran group than those in the rivaroxaban group. Mean ACT (280 ± 36 s vs. 265 ± 30 s, P < 0.05), and the percentage of ACTs within the therapeutic range (250–350 s) (74％ ± 26％ vs. 60％ ± 29％, P < 0.05) were significantly lower in the dabigatran group than those in the rivaroxaban group, particularly in male pati-ents. Furthermore, the average time of achieving the target ACT (250–350 s) was also found longer in the dabigatran group (P <0.05) as compared with the rivaroxaban group. No significant difference was found in the incidence of periprocedural complica-tions between the two groups. CONCLUSIONS The anticoagulant effect of uninterrupted rivaroxaban therapy appears to be more stable and efficient than dabigatran administration during catheter ablation in patients with AF.
机标关键词：idealtimewithablationachievingactivatedatrialcatheter
论文发表日期：2022-08-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 565-574 )