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35 Uninterrupted edoxaban versus rivaroxaban versus vitamin K antagonists for ablation of atrial fibrillation
  1. Noha Elbanhawy,
  2. Mark Ainslie,
  3. Sherif Eltouky,
  4. Rahul Potluri,
  5. Scott Gall,
  6. Shajil Chalil,
  7. Khalid Abozguia
  1. Cardiology Department, Lancashire Cardiac Centre, Blackpool Teaching Hospitals, Blackpool UK

Abstract

Background Catheter ablation in patients with atrial fibrillation/flutter is associated with a risk of stroke and major bleeding. We examined the safety and efficacy of uninterrupted anticoagulation with Edoxaban in patients undergoing atrial fibrillation/flutter ablation.

Methods A retrospective analysis of 228 patients undergoing a catheter ablation for atrial flutter or atrial fibrillation over a 14 month period was performed (table 1). The warfarin group (n=86) included 52 males and 34 females with a mean age of 68.5±years and a mean CHADS-Vasc Score of 2.43±1.34. The Edoxaban group (n=63) included 45 males and 18 females with mean age 63.4±10.6 years and a mean CHADS-Vasc Score of 1.68±1.34. The Rivaroxaban group (n=79) included 56 males and 23 females, mean age 62.3±11.6 years and a CHADS- Vasc Score of 1.64±1.38. The mean left atrial sizes were 42.7±6.8 mm, 42.0±6 mm and 41.1±6.5 mm respectively (P value=0.473). All patients received uninterrupted oral anticoagulation for at least 4 weeks prior to the ablation and for a minimum of 3 months post procedure. Both bleeding and thromboembolic complications were assessed at 24 hours.

Abstract 35 Table 1

Procedure Characteristics: Continuous variables reported as a mean±standard deviation (SD)

Results Data between the Warfarin, Rivaroxaban and Edoxaban groups were analysed using a multivariate analysis. Warfarin was used as the reference group with age and gender as covariates. Acute thromboembolic, bleeding and other less common complications were compared (table 2). There were 4 complications (4.6%) in the warfarin, 2 (2.5%) in the Rivaroxaban and 2 (3%) in the Edoxaban groups, respectively. (P value=0.9).

Abstract 35 Table 2

Acute complications: Table showing complications during and 24 hours following procedures for the Edoxaban and Rivaroxaban compared to warfarin. Note there was no significant difference between the three groups in terms of primary endpoints of major bleeding and thromboembolic complications. Categorical data were represented as numbers. CVA: Cerebrovascular accident, TIA: Transient ischemic attack, PCI: percutaneous coronary intervention.

Conclusion This retrospective study demonstrated that uninterrupted Edoxaban is as safe and effective as warfarin and Rivaroxaban in patients undergoing atrial fibrillation/ flutter ablations. There was no significant difference in acute bleeding and thromboembolic complications.

  • Atrial fibrillation
  • Direct oral anticoagulants
  • Catheter ablation

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