| Radiofrequency ablation of atrial fibrillation under therapeutic international normalized ratio: a safe and efficacious periprocedural anticoagulation strategy. | |
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MedLine Citation:
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PMID: 19968920 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: The best periprocedural anticoagulation strategy at the time of pulmonary vein isolation (PVI) is not known. Most centers stop administering warfarin (Coumadin) and use bridging with heparin or enoxaparin. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of PVI under therapeutic international normalized ratio (INR). METHODS: Between January 2005 and December 2008, PVI was performed in 3,052 patients with therapeutic INR (> or =1.8) at the time of ablation. All patients were evaluated for ischemic strokes and bleeding complications. RESULTS: Mean INR was 2.53 +/- 0.62. Only 3 (0.098%) patients had ischemic strokes. One patient had a hemorrhagic stroke on the third day postablation but recovered completely by 1-week follow-up. Bleeding complications occurred in 34 (1.11%) patients; most were minor (0.79%). Major hemorrhagic complications occurred in 10 (0.33%) patients (tamponade in 5, hematomas requiring intervention in 2, transfusion necessary in 3). CONCLUSION: In a large patient population, continuation of Coumadin at a therapeutic INR at the time of PVI without use of heparin or enoxaparin for bridging is a safe and efficacious periprocedural anticoagulation strategy. It is an acceptable and potentially better alternative to strategies that use bridging with heparin or enoxaparin. |
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Authors:
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Ayman A Hussein; David O Martin; Walid Saliba; Deven Patel; Saima Karim; Omar Batal; Mustafa Banna; Michelle Williams-Andrews; Minerva Sherman; Mohamed Kanj; Mandeep Bhargava; Thomas Dresing; Thomas Callahan; Patrick Tchou; Luigi Di Biase; Salwa Beheiry; Bruce Lindsay; Andrea Natale; Oussama Wazni |
Publication Detail:
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Type: Journal Article Date: 2009-07-10 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 6 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-12-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 1425-9 Citation Subset: IM |
Affiliation:
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Center for Atrial Fibrillation, Cleveland Clinic, Cleveland, OH, USA. |
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Comment In:
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Heart Rhythm. 2009 Oct;6(10):1430-1
[PMID:
19968921
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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