Have I missed something here?

David E Ward, Cardiologist,
October 17, 2013

Am I missing something here? It is generally accepted that the omission of a single dose of dabigatran, which has a short elimination half-life, may place a patient at risk of thromboembolism. So why should atrial fibrillation ablation be any different especially when one is potentially stimulating thrombus formation in the left atrium during and possibly after the procedure? Why not continue the drug through the procedure as reported by Maddox et al (1)? Is it not completely illogical to do otherwise? More trials of this approach are needed. Abdulhak's meta- analysis (his reference 2) did not include any studies of uninterrupted dabigatran treatment.

Reference

1.Maddox W, Kay GN, Yamada T et al. Dabigatran versus warfarin for uninterrupted oral anticoagulation during atrial fibrillation ablation. Journal of Cardiac Electrophysiology 2013;24:861-865

Conflict of Interest:

None declared

Conflict of Interest

None declared