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.
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).
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.
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