Document Detail

The use of anticoagulation during the periprocedure period of atrial fibrillation ablation.
MedLine Citation:
PMID:  22146378     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: Ablation is a treatment option for selected patients with atrial fibrillation that is being used more frequently, increasing the importance of awareness of both its risks and benefits. This review discusses the thromboembolic and bleeding risks during ablation, strategies to minimize these risks and use of long-term oral anticoagulation post ablation.
RECENT FINDINGS: Thromboembolic and bleeding risks imparted by atrial fibrillation ablation can be minimized by echocardiography, optimal intraprocedural anticoagulation, and use of irrigated catheters and access sheaths with constant heparinized saline flow. Additionally, a strategic approach to periprocedural anticoagulation that may include continuation of warfarin, bridging with low-molecular-weight heparin (LMWH), or use of aspirin alone is essential in the balance of thrombotic and hemorrhagic risks. Novel anticoagulants (direct thrombin inhibitors or anti-Xa inhibitors) may add further options.
SUMMARY: The use of atrial fibrillation ablation has increased over the past decade. Along with technique and technology advances that have improved the success of ablation, strides have been made in minimizing thromboembolic and bleeding risks and in the availability of a broader choice of anticoagulants. Research is ongoing to identify patients most suitable for ablation and to determine the long-term efficacy and safety of this treatment option.
Atul Verma; Bernice Tsang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  27     ISSN:  1531-7080     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55-61     Citation Subset:  IM    
Southlake Heart Rhythm Program, Division of Cardiology, Southlake Regional Health Centre, Newmarket, Ontario, Canada.
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