Login Register Cart 0
Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Antithrombotic Treatment after Atrial Fibrillation Ablation

Author(s): Christos-Konstantinos Antoniou*, Panagiota Manolakou, Petros Arsenos, Polychronis Dilaveris, Konstantinos Gatzoulis and Dimitrios Tousoulis

Volume 26, Issue 23, 2020

Page: [2703 - 2714] Pages: 12

DOI: 10.2174/1381612826666200407154329

Price: $65

Abstract

Atrial fibrillation is a major cause of debilitating strokes and anticoagulation is an established and indispensable therapy for reducing their rate. Ablation of the arrhythmia has emerged as a putative means of disrupting its natural course by isolating its triggers and modifying its substrate, dependent on the chosen method. An important dilemma lies in the need for continuation of anticoagulation therapy in those previously receiving it following an, apparently, successful intervention, purportedly preventing arrhythmia recurrence with considerably high rates. Current guidance, given scarcity of high-quality data from randomized trials, focuses on established knowledge and recommends anticoagulation continuation based solely on estimated thromboembolic risk. In the present review, it will be attempted to summarize the pathophysiological rationale for maintaining anticoagulation post-successful ablation, along with the latter’s definition, including the two-fold effects of the procedure per se on thrombogenicity. Available evidence pointing to an overall clinical benefit of anticoagulation withdrawal following careful patient assessment will be discussed, including ongoing randomized trials aiming to offer definitive answers. Finally, the proposed mode of post-ablation anticoagulation will be presented, including the emerging, guideline-endorsed, role of direct oral anticoagulants in the field, altering cost/benefit ratio of anticoagulation and potentially affecting the very decision regarding its discontinuation.

Keywords: Atrial fibrillation, ablation, anticoagulation, thromboembolic risk modulators, atrial myopathy, OCEAN trial, direct oral anticoagulants, left atrial appendage closure.

« Previous Next »
[1]
Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 2017; 14(10): e275-444.
[http://dx.doi.org/10.1016/j.hrthm.2017.05.012] [PMID: 28506916]
[2]
Kuck K-H, Brugada J, Fürnkranz A, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med 2016; 374(23): 2235-45.
[http://dx.doi.org/10.1056/NEJMoa1602014] [PMID: 27042964]
[3]
Santarpia G, De Rosa S, Sabatino J, Curcio A, Indolfi C. Should We Maintain Anticoagulation after Successful Radiofrequency Catheter Ablation of Atrial Fibrillation? The Need for a Randomized Study. Front Cardiovasc Med 2017; 4(85): 85.
[http://dx.doi.org/10.3389/fcvm.2017.00085] [PMID: 29312960]
[4]
Arbelo E, Brugada J, Blomström-Lundqvist C, et al. Contemporary management of patients undergoing atrial fibrillation ablation: in-hospital and 1-year follow-up findings from the ESC-EHRA atrial fibrillation ablation long-term registry. Eur Heart J 2017; 38(17): 1303-16.
[http://dx.doi.org/10.1093/eurheartj/ehw564] [PMID: 28104790]
[5]
Verma A, Macle L, Cox J, Skanes AC. Canadian Cardiovascular Society atrial fibrillation guidelines 2010: catheter ablation for atrial fibrillation/atrial flutter. Can J Cardiol 2011; 27(1): 60-6.
[http://dx.doi.org/10.1016/j.cjca.2010.11.011] [PMID: 21329863]
[6]
Packer DL, Mark DB, Robb RA, et al. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA 2019; 321(13): 1261-74.
[http://dx.doi.org/10.1001/jama.2019.0693] [PMID: 30874766]
[7]
Cappato R, Calkins H, Chen SA, et al. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol 2010; 3(1): 32-8.
[http://dx.doi.org/10.1161/CIRCEP.109.859116] [PMID: 19995881]
[8]
Prabhu S, Taylor AJ, Costello BT, et al. Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Systolic Dysfunction: The CAMERA-MRI Study. J Am Coll Cardiol 2017; 70(16): 1949-61.
[http://dx.doi.org/10.1016/j.jacc.2017.08.041] [PMID: 28855115]
[9]
Marrouche NF, Brachmann J, Andresen D, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med 2018; 378(5): 417-27.
[http://dx.doi.org/10.1056/NEJMoa1707855] [PMID: 29385358]
[10]
January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation 2019; 140(2): e125-51.
[http://dx.doi.org/10.1161/CIR.0000000000000665] [PMID: 30686041]
[11]
Themistoclakis S, Corrado A, Marchlinski FE, et al. The risk of thromboembolism and need for oral anticoagulation after successful atrial fibrillation ablation. J Am Coll Cardiol 2010; 55(8): 735-43.
[http://dx.doi.org/10.1016/j.jacc.2009.11.039] [PMID: 20170810]
[12]
Nademanee K, Schwab MC, Kosar EM, et al. Clinical outcomes of catheter substrate ablation for high-risk patients with atrial fibrillation. J Am Coll Cardiol 2008; 51(8): 843-9.
[http://dx.doi.org/10.1016/j.jacc.2007.10.044] [PMID: 18294570]
[13]
Oral H, Chugh A, Ozaydin M, et al. Risk of thromboembolic events after percutaneous left atrial radiofrequency ablation of atrial fibrillation. Circulation 2006; 114(8): 759-65.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.106.641225] [PMID: 16908760]
[14]
Rossillo A, Bonso A, Themistoclakis S, et al. Role of anticoagulation therapy after pulmonary vein antrum isolation for atrial fibrillation treatment. J Cardiovasc Med (Hagerstown) 2008; 9(1): 51-5.
[http://dx.doi.org/10.2459/JCM.0b013e32801462d4] [PMID: 18268419]
[15]
Bunch TJ, Crandall BG, Weiss JP, et al. Warfarin is not needed in low-risk patients following atrial fibrillation ablation procedures. J Cardiovasc Electrophysiol 2009; 20(9): 988-93.
[http://dx.doi.org/10.1111/j.1540-8167.2009.01481.x] [PMID: 19473299]
[16]
Saad EB, d’Avila A, Costa IP, et al. Very low risk of thromboembolic events in patients undergoing successful catheter ablation of atrial fibrillation with a CHADS2 score ≤3: a long-term outcome study. Circ Arrhythm Electrophysiol 2011; 4(5): 615-21.
[http://dx.doi.org/10.1161/CIRCEP.111.963231] [PMID: 21841192]
[17]
Yagishita A, Takahashi Y, Takahashi A, et al. Incidence of late thromboembolic events after catheter ablation of atrial fibrillation. Circ J 2011; 75(10): 2343-9.
[http://dx.doi.org/10.1253/circj.CJ-11-0065] [PMID: 21778595]
[18]
Guiot A, Jongnarangsin K, Chugh A, et al. Anticoagulant therapy and risk of cerebrovascular events after catheter ablation of atrial fibrillation in the elderly. J Cardiovasc Electrophysiol 2012; 23(1): 36-43.
[http://dx.doi.org/10.1111/j.1540-8167.2011.02141.x] [PMID: 21806701]
[19]
Winkle RA, Mead RH, Engel G, Kong MH, Patrawala RA. Discontinuing anticoagulation following successful atrial fibrillation ablation in patients with prior strokes. J Interv Card Electrophysiol 2013; 38(3): 147-53.
[http://dx.doi.org/10.1007/s10840-013-9835-1] [PMID: 24101149]
[20]
Gaita F, Sardi D, Battaglia A, et al. Incidence of cerebral thromboembolic events during long-term follow-up in patients treated with transcatheter ablation for atrial fibrillation. Europace 2014; 16(7): 980-6.
[http://dx.doi.org/10.1093/europace/eut406] [PMID: 24446510]
[21]
Ha AC, Hindricks G, Birnie DH, Verma A. Long-term oral anticoagulation for patients after successful catheter ablation of atrial fibrillation: is it necessary? Curr Opin Cardiol 2015; 30(1): 1-7.
[http://dx.doi.org/10.1097/HCO.0000000000000121] [PMID: 25389647]
[22]
Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37(38): 2893-962.
[http://dx.doi.org/10.1093/eurheartj/ehw210] [PMID: 27567408]
[23]
January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014; 130(23): e199-267.
[http://dx.doi.org/10.1161/CIR.0000000000000041] [PMID: 24682347]
[24]
Ezekowitz MD, Bridgers SL, James KE, et al. Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. N Engl J Med 1992; 327(20): 1406-12.
[http://dx.doi.org/10.1056/NEJM199211123272002] [PMID: 1406859]
[25]
Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365(10): 883-91.
[http://dx.doi.org/10.1056/NEJMoa1009638] [PMID: 21830957]
[26]
Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361(12): 1139-51.
[http://dx.doi.org/10.1056/NEJMoa0905561] [PMID: 19717844]
[27]
Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365(11): 981-92.
[http://dx.doi.org/10.1056/NEJMoa1107039] [PMID: 21870978]
[28]
Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013; 369(22): 2093-104.
[http://dx.doi.org/10.1056/NEJMoa1310907] [PMID: 24251359]
[29]
Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 2010; 137(2): 263-72.
[http://dx.doi.org/10.1378/chest.09-1584] [PMID: 19762550]
[30]
Yao C, Veleva T, Scott L Jr, et al. Enhanced Cardiomyocyte NLRP3 Inflammasome Signaling Promotes Atrial Fibrillation. Circulation 2018; 138(20): 2227-42.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.118.035202] [PMID: 29802206]
[31]
Hu YF, Chen YJ, Lin YJ, Chen SA. Inflammation and the pathogenesis of atrial fibrillation. Nat Rev Cardiol 2015; 12(4): 230-43.
[http://dx.doi.org/10.1038/nrcardio.2015.2] [PMID: 25622848]
[32]
Castellano JM, Chinitz J, Willner J, Fuster V. Mechanisms of stroke in atrial fibrillation. Card Electrophysiol Clin 2014; 6(1): 5-15.
[http://dx.doi.org/10.1016/j.ccep.2013.10.007] [PMID: 27063817]
[33]
Guo Y, Lip GY, Apostolakis S. Inflammation in atrial fibrillation. J Am Coll Cardiol 2012; 60(22): 2263-70.
[http://dx.doi.org/10.1016/j.jacc.2012.04.063] [PMID: 23194937]
[34]
Masci A, Barone L, Dedè L, et al. The Impact of Left Atrium Appendage Morphology on Stroke Risk Assessment in Atrial Fibrillation: A Computational Fluid Dynamics Study. Front Physiol 2019; 9: 1938.
[http://dx.doi.org/10.3389/fphys.2018.01938] [PMID: 30723422]
[35]
Di Biase L, Santangeli P, Anselmino M, et al. Does the left atrial appendage morphology correlate with the risk of stroke in patients with atrial fibrillation? Results from a multicenter study. J Am Coll Cardiol 2012; 60(6): 531-8.
[http://dx.doi.org/10.1016/j.jacc.2012.04.032] [PMID: 22858289]
[36]
Hindricks G, Pokushalov E, Urban L, et al. Performance of a new leadless implantable cardiac monitor in detecting and quantifying atrial fibrillation: Results of the XPECT trial. Circ Arrhythm Electrophysiol 2010; 3(2): 141-7.
[http://dx.doi.org/10.1161/CIRCEP.109.877852] [PMID: 20160169]
[37]
Erküner Ö, Rienstra M, Van Gelder IC, Schotten U, Crijns HJGM, Luermans JGLM. Stroke risk in patients with device-detected atrial high-rate episodes. Neth Heart J 2018; 26(4): 177-81.
[PMID: 29058207]
[38]
Healey JS, Connolly SJ, Gold MR, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med 2012; 366(2): 120-9.
[http://dx.doi.org/10.1056/NEJMoa1105575] [PMID: 22236222]
[39]
Van Gelder IC, Healey JS, Crijns HJGM, et al. Duration of device-detected subclinical atrial fibrillation and occurrence of stroke in ASSERT. Eur Heart J 2017; 38(17): 1339-44.
[http://dx.doi.org/10.1093/eurheartj/ehx042] [PMID: 28329139]
[40]
Viles-Gonzalez JF, Mehta D. Thromboembolic risk and anticoagulation strategies in patients undergoing catheter ablation for atrial fibrillation. Curr Cardiol Rep 2011; 13(1): 38-42.
[http://dx.doi.org/10.1007/s11886-010-0153-2] [PMID: 21057900]
[41]
Mardigyan V, Verma A, Birnie D, et al. Anticoagulation management pre- and post atrial fibrillation ablation: a survey of canadian centres. Can J Cardiol 2013; 29(2): 219-23.
[http://dx.doi.org/10.1016/j.cjca.2012.04.013] [PMID: 22840300]
[42]
Weerasooriya R, Khairy P, Litalien J, et al. Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? J Am Coll Cardiol 2011; 57(2): 160-6.
[http://dx.doi.org/10.1016/j.jacc.2010.05.061] [PMID: 21211687]
[43]
Sanna T, Diener H-C, Passman RS, et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med 2014; 370(26): 2478-86.
[http://dx.doi.org/10.1056/NEJMoa1313600] [PMID: 24963567]
[44]
Steven D, Rostock T, Lutomsky B, et al. What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring. Eur Heart J 2008; 29(8): 1037-42.
[http://dx.doi.org/10.1093/eurheartj/ehn024] [PMID: 18263865]
[45]
Page RL, Wilkinson WE, Clair WK, McCarthy EA, Pritchett EL. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 1994; 89(1): 224-7.
[http://dx.doi.org/10.1161/01.CIR.89.1.224] [PMID: 8281651]
[46]
Chao TF, Liu CJ, Chen SJ, et al. Atrial fibrillation and the risk of ischemic stroke: does it still matter in patients with a CHA2DS2-VASc score of 0 or 1? Stroke 2012; 43(10): 2551-5.
[http://dx.doi.org/10.1161/STROKEAHA.112.667865] [PMID: 22871677]
[47]
Kamel H, Okin PM, Elkind MS, Iadecola C. Atrial Fibrillation and Mechanisms of Stroke: Time for a New Model. Stroke 2016; 47(3): 895-900.
[http://dx.doi.org/10.1161/STROKEAHA.115.012004] [PMID: 26786114]
[48]
Khoo CW, Krishnamoorthy S, Lim HS, Lip GY. Atrial fibrillation, arrhythmia burden and thrombogenesis. Int J Cardiol 2012; 157(3): 318-23.
[http://dx.doi.org/10.1016/j.ijcard.2011.06.088] [PMID: 21726909]
[49]
Spence JD. Cardioembolic stroke: everything has changed. Stroke Vasc Neurol 2018; 3(2): 76-83.
[http://dx.doi.org/10.1136/svn-2018-000143] [PMID: 30022801]
[50]
Lijfering WM, Flinterman LE, Vandenbroucke JP, Rosendaal FR, Cannegieter SC. Relationship between venous and arterial thrombosis: a review of the literature from a causal perspective. Semin Thromb Hemost 2011; 37(8): 885-96.
[http://dx.doi.org/10.1055/s-0031-1297367] [PMID: 22198853]
[51]
Hahne M, Jäger U, Isenmann S, Hallmann R, Vestweber D. Five tumor necrosis factor-inducible cell adhesion mechanisms on the surface of mouse endothelioma cells mediate the binding of leukocytes. J Cell Biol 1993; 121(3): 655-64.
[http://dx.doi.org/10.1083/jcb.121.3.655] [PMID: 7683689]
[52]
Hattori R, Hamilton KK, Fugate RD, McEver RP, Sims PJ. Stimulated secretion of endothelial von Willebrand factor is accompanied by rapid redistribution to the cell surface of the intracellular granule membrane protein GMP-140. J Biol Chem 1989; 264(14): 7768-71.
[PMID: 2470733]
[53]
Marín F, Roldán V, Lip GY. Fibrinolytic function and atrial fibrillation. Thromb Res 2003; 109(5-6): 233-40.
[http://dx.doi.org/10.1016/S0049-3848(03)00259-7] [PMID: 12818244]
[54]
Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345(7): 494-502.
[http://dx.doi.org/10.1056/NEJMoa010746] [PMID: 11519503]
[55]
Kamath S, Blann AD, Chin BS, Lip GY. A prospective randomized trial of aspirin-clopidogrel combination therapy and dose-adjusted warfarin on indices of thrombogenesis and platelet activation in atrial fibrillation. J Am Coll Cardiol 2002; 40(3): 484-90.
[http://dx.doi.org/10.1016/S0735-1097(02)01984-8] [PMID: 12142115]
[56]
Masuda M, Fujita M, Iida O, et al. Left atrial low-voltage areas predict atrial fibrillation recurrence after catheter ablation in patients with paroxysmal atrial fibrillation. Int J Cardiol 2018; 257: 97-101.
[http://dx.doi.org/10.1016/j.ijcard.2017.12.089] [PMID: 29506746]
[57]
Siebermair J, Suksaranjit P, McGann CJ, et al. Atrial fibrosis in non-atrial fibrillation individuals and prediction of atrial fibrillation by use of late gadolinium enhancement magnetic resonance imaging. J Cardiovasc Electrophysiol 2019; 30(4): 550-6.
[http://dx.doi.org/10.1111/jce.13846] [PMID: 30661270]
[58]
Akoum N, Daccarett M, McGann C, et al. Atrial fibrosis helps select the appropriate patient and strategy in catheter ablation of atrial fibrillation: a DE-MRI guided approach. J Cardiovasc Electrophysiol 2011; 22(1): 16-22.
[http://dx.doi.org/10.1111/j.1540-8167.2010.01876.x] [PMID: 20807271]
[59]
Sherman DG, Kim SG, Boop BS, et al. Occurrence and characteristics of stroke events in the Atrial Fibrillation Follow-up Investigation of Sinus Rhythm Management (AFFIRM) study. Arch Intern Med 2005; 165(10): 1185-91.
[http://dx.doi.org/10.1001/archinte.165.10.1185] [PMID: 15911734]
[60]
Thibault B, Talajic M, Dubuc M, et al. Thromboembolic events occur despite sinus rhythm maintenance in patients treated for atrial fibrillation: The Canadian Trial of Atrial Fibrillation experience. Can J Cardiol 2004; 20(2): 195-9.
[PMID: 15010743]
[61]
De Jong AM, Maass AH, Oberdorf-Maass SU, Van Veldhuisen DJ, Van Gilst WH, Van Gelder IC. Mechanisms of atrial structural changes caused by stretch occurring before and during early atrial fibrillation. Cardiovasc Res 2011; 89(4): 754-65.
[http://dx.doi.org/10.1093/cvr/cvq357] [PMID: 21075756]
[62]
Lappegård KT, Hovland A, Pop GA, Mollnes TE. Atrial fibrillation: inflammation in disguise? Scand J Immunol 2013; 78(2): 112-9.
[http://dx.doi.org/10.1111/sji.12061] [PMID: 23672430]
[63]
Niespialowska-Steuden M, Markides V, Farag M, et al. Catheter ablation for AF improves global thrombotic profile and enhances fibrinolysis. J Thromb Thrombolysis 2017; 44(4): 413-26.
[http://dx.doi.org/10.1007/s11239-017-1548-3] [PMID: 28921408]
[64]
Guthikonda S, Haynes WG. Homocysteine: role and implications in atherosclerosis. Curr Atheroscler Rep 2006; 8(2): 100-6.
[http://dx.doi.org/10.1007/s11883-006-0046-4] [PMID: 16510043]
[65]
Chesebro JH, Fuster V, Halperin JL. Atrial fibrillation--risk marker for stroke. N Engl J Med 1990; 323(22): 1556-8.
[http://dx.doi.org/10.1056/NEJM199011293232209] [PMID: 2233936]
[66]
Lombardo RM, Reina C, Abrignani MG, Braschi A, De Castro S. Embolic stroke, sinus rhythm and left atrial mechanical function. Eur J Echocardiogr 2006; 7(5): 401-4.
[http://dx.doi.org/10.1016/j.euje.2005.07.014] [PMID: 16198150]
[67]
Kim YD, Cha MJ, Kim J, et al. Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. Stroke 2011; 42(4): 930-4.
[http://dx.doi.org/10.1161/STROKEAHA.110.602987] [PMID: 21350200]
[68]
Chen PS, Chen LS, Fishbein MC, Lin SF, Nattel S. Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy. Circ Res 2014; 114(9): 1500-15.
[http://dx.doi.org/10.1161/CIRCRESAHA.114.303772] [PMID: 24763467]
[69]
Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104(24): 2886-91.
[http://dx.doi.org/10.1161/hc4901.101760] [PMID: 11739301]
[70]
Al-Khatib SM, Allen LaPointe NM, Chatterjee R, et al. Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review. Ann Intern Med 2014; 160(11): 760-73.
[http://dx.doi.org/10.7326/M13-1467] [PMID: 24887617]
[71]
Bunch TJ, Gersh BJ. Rhythm control strategies and the role of antiarrhythmic drugs in the management of atrial fibrillation: focus on clinical outcomes. J Gen Intern Med 2011; 26(5): 531-7.
[http://dx.doi.org/10.1007/s11606-010-1574-8] [PMID: 21108047]
[72]
Corley SD, Epstein AE, DiMarco JP, et al. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation 2004; 109(12): 1509-13.
[http://dx.doi.org/10.1161/01.CIR.0000121736.16643.11] [PMID: 15007003]
[73]
Rotter M, Jaïs P, Vergnes MC, et al. Decline in C-reactive protein after successful ablation of long-lasting persistent atrial fibrillation. J Am Coll Cardiol 2006; 47(6): 1231-3.
[http://dx.doi.org/10.1016/j.jacc.2005.12.038] [PMID: 16545659]
[74]
Jin M, Song C, Shim J, et al. Risk of ischemic stroke in patients after successful radiofrequency catheter ablation. ACC13 American College of Cardiology 62nd Annual Scientific Session & Expo; March 12 2013; San Francisco:. J Am Coll Cardiol. E383.
[75]
Sticherling C, Marin F, Birnie D, et al. Antithrombotic management in patients undergoing electrophysiological procedures: a European Heart Rhythm Association (EHRA) position document endorsed by the ESC Working Group Thrombosis, Heart Rhythm Society (HRS), and Asia Pacific Heart Rhythm Society (APHRS). Europace 2015; 17(8): 1197-214.
[http://dx.doi.org/10.1093/europace/euv190] [PMID: 26105732]
[76]
Haeusler KG, Kirchhof P, Endres M. Left atrial catheter ablation and ischemic stroke. Stroke 2012; 43(1): 265-70.
[http://dx.doi.org/10.1161/STROKEAHA.111.627067] [PMID: 22156699]
[77]
Nakamura T, Okishige K, Kanazawa T, et al. Incidence of silent cerebral infarctions after catheter ablation of atrial fibrillation utilizing the second-generation cryoballoon. Europace 2017; 19(10): 1681-8.
[http://dx.doi.org/10.1093/europace/euw191] [PMID: 27702854]
[78]
Herm J, Fiebach JB, Koch L, et al. Neuropsychological effects of MRI-detected brain lesions after left atrial catheter ablation for atrial fibrillation: long-term results of the MACPAF study. Circ Arrhythm Electrophysiol 2013; 6(5): 843-50.
[http://dx.doi.org/10.1161/CIRCEP.113.000174] [PMID: 23989301]
[79]
Benameur K, Bykowski JL, Luby M, Warach S, Latour LL. Higher prevalence of cortical lesions observed in patients with acute stroke using high-resolution diffusion-weighted imaging. AJNR Am J Neuroradiol 2006; 27(9): 1987-9.
[PMID: 17032880]
[80]
Deneke T, Shin DI, Balta O, et al. Postablation asymptomatic cerebral lesions: long-term follow-up using magnetic resonance imaging. Heart Rhythm 2011; 8(11): 1705-11.
[http://dx.doi.org/10.1016/j.hrthm.2011.06.030] [PMID: 21726519]
[81]
Kuwahara T, Abe M, Yamaki M, et al. Apixaban versus Warfarin for the Prevention of Periprocedural Cerebral Thromboembolism in Atrial Fibrillation Ablation: Multicenter Prospective Randomized Study. J Cardiovasc Electrophysiol 2016; 27(5): 549-54.
[http://dx.doi.org/10.1111/jce.12928] [PMID: 26766541]
[82]
Wylie JV Jr, Peters DC, Essebag V, Manning WJ, Josephson ME, Hauser TH. Left atrial function and scar after catheter ablation of atrial fibrillation. Heart Rhythm 2008; 5(5): 656-62.
[http://dx.doi.org/10.1016/j.hrthm.2008.02.008] [PMID: 18452866]
[83]
Skanes AC, Healey JS, Cairns JA, et al. Focused 2012 update of the Canadian Cardiovascular Society atrial fibrillation guidelines: recommendations for stroke prevention and rate/rhythm control. Can J Cardiol 2012; 28(2): 125-36.
[http://dx.doi.org/10.1016/j.cjca.2012.01.021] [PMID: 22433576]
[84]
Blanc JJ, Almendral J, Brignole M, et al. Consensus document on antithrombotic therapy in the setting of electrophysiological procedures. Europace 2008; 10(5): 513-27.
[http://dx.doi.org/10.1093/europace/eun104] [PMID: 18442963]
[85]
Peters DC, Wylie JV, Hauser TH, et al. Recurrence of atrial fibrillation correlates with the extent of post-procedural late gadolinium enhancement: a pilot study. JACC Cardiovasc Imaging 2009; 2(3): 308-16.
[http://dx.doi.org/10.1016/j.jcmg.2008.10.016] [PMID: 19356576]
[86]
Lemola K, Desjardins B, Sneider M, et al. Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function. Heart Rhythm 2005; 2(9): 923-8.
[http://dx.doi.org/10.1016/j.hrthm.2005.06.026] [PMID: 16171744]
[87]
Cochet H, Scherr D, Zellerhoff S, et al. Atrial structure and function 5 years after successful ablation for persistent atrial fibrillation: an MRI study. J Cardiovasc Electrophysiol 2014; 25(7): 671-9.
[http://dx.doi.org/10.1111/jce.12449] [PMID: 24798070]
[88]
Karch MR, Zrenner B, Deisenhofer I, et al. Freedom from atrial tachyarrhythmias after catheter ablation of atrial fibrillation: a randomized comparison between 2 current ablation strategies. Circulation 2005; 111(22): 2875-80.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.104.491530] [PMID: 15927974]
[89]
Wójcik M, Berkowitsch A, Zaltsberg S, et al. Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: long-term follow-up. Cardiol J 2015; 22(5): 557-66.
[http://dx.doi.org/10.5603/CJ.a2015.0040] [PMID: 26202652]
[90]
Reant P, Lafitte S, Jaïs P, et al. Reverse remodeling of the left cardiac chambers after catheter ablation after 1 year in a series of patients with isolated atrial fibrillation. Circulation 2005; 112(19): 2896-903.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.104.523928] [PMID: 16260634]
[91]
Beukema WP, Elvan A, Sie HT, Misier AR, Wellens HJ. Successful radiofrequency ablation in patients with previous atrial fibrillation results in a significant decrease in left atrial size. Circulation 2005; 112(14): 2089-95.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.104.484766] [PMID: 16203925]
[92]
Verma A, Kilicaslan F, Adams JR, et al. Extensive ablation during pulmonary vein antrum isolation has no adverse impact on left atrial function: an echocardiography and cine computed tomography analysis. J Cardiovasc Electrophysiol 2006; 17(7): 741-6.
[http://dx.doi.org/10.1111/j.1540-8167.2006.00488.x] [PMID: 16836670]
[93]
Takahashi Y, O’Neill MD, Hocini M, et al. Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties. J Am Coll Cardiol 2007; 49(12): 1306-14.
[http://dx.doi.org/10.1016/j.jacc.2006.11.033] [PMID: 17394963]
[94]
Sacher F, Corcuff JB, Schraub P, et al. Chronic atrial fibrillation ablation impact on endocrine and mechanical cardiac functions. Eur Heart J 2008; 29(10): 1290-5.
[http://dx.doi.org/10.1093/eurheartj/ehm577] [PMID: 18077441]
[95]
Gentlesk PJ, Sauer WH, Gerstenfeld EP, et al. Reversal of left ventricular dysfunction following ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2007; 18(1): 9-14.
[http://dx.doi.org/10.1111/j.1540-8167.2006.00653.x] [PMID: 17081210]
[96]
Gopinathannair R, Etheridge SP, Marchlinski FE, Spinale FG, Lakkireddy D, Olshansky B. Arrhythmia-Induced Cardiomyopathies: Mechanisms, Recognition, and Management. J Am Coll Cardiol 2015; 66(15): 1714-28.
[http://dx.doi.org/10.1016/j.jacc.2015.08.038] [PMID: 26449143]
[97]
Martin CA, Lambiase PD. Pathophysiology, diagnosis and treatment of tachycardiomyopathy. Heart 2017; 103(19): 1543-52.
[http://dx.doi.org/10.1136/heartjnl-2016-310391] [PMID: 28855272]
[98]
Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 1996; 61(2): 755-9.
[http://dx.doi.org/10.1016/0003-4975(95)00887-X] [PMID: 8572814]
[99]
Carlson SK, Doshi RN. Termination of anticoagulation therapy at 45 days after concomitant atrial fibrillation catheter ablation and left atrial appendage occlusion resulting in device-related thrombosis and stroke. HeartRhythm Case Rep 2017; 3(1): 18-21.
[http://dx.doi.org/10.1016/j.hrcr.2016.11.008] [PMID: 28491759]
[100]
Mohanty S, Mohanty P, Trivedi C, et al. Long-Term Outcome of Pulmonary Vein Isolation With and Without Focal Impulse and Rotor Modulation Mapping: Insights From a Meta-Analysis. Circ Arrhythm Electrophysiol 2018; 11(3)e005789
[http://dx.doi.org/10.1161/CIRCEP.117.005789] [PMID: 29545360]
[101]
Yasuda R, Murata M, Roberts R, et al. Left atrial strain is a powerful predictor of atrial fibrillation recurrence after catheter ablation: study of a heterogeneous population with sinus rhythm or atrial fibrillation. Eur Heart J Cardiovasc Imaging 2015; 16(9): 1008-14.
[http://dx.doi.org/10.1093/ehjci/jev028] [PMID: 25750193]
[102]
Ma XX, Zhang YL, Hu B, et al. The usefulness of global left atrial strain for predicting atrial fibrillation recurrence after catheter ablation in patients with persistent and paroxysmal atrial fibrillation. Arch Cardiovasc Dis 2017; 110(8-9): 447-55.
[http://dx.doi.org/10.1016/j.acvd.2016.11.005] [PMID: 28528995]
[103]
Parwani AS, Morris DA, Blaschke F, et al. Left atrial strain predicts recurrence of atrial arrhythmias after catheter ablation of persistent atrial fibrillation. Open Heart 2017; 4(1)e000572
[http://dx.doi.org/10.1136/openhrt-2016-000572] [PMID: 28674624]
[104]
Karasoy D, Gislason GH, Hansen J, et al. Oral anticoagulation therapy after radiofrequency ablation of atrial fibrillation and the risk of thromboembolism and serious bleeding: long-term follow-up in nationwide cohort of Denmark. Eur Heart J 2015; 36(5): 307-14a.
[http://dx.doi.org/10.1093/eurheartj/ehu421] [PMID: 25368205]
[105]
Uhm JS, Won H, Joung B, et al. Safety and efficacy of switching anticoagulation to aspirin three months after successful radiofrequency catheter ablation of atrial fibrillation. Yonsei Med J 2014; 55(5): 1238-45.
[http://dx.doi.org/10.3349/ymj.2014.55.5.1238] [PMID: 25048480]
[106]
Själander S, Holmqvist F, Smith JG, et al. Assessment of Use vs Discontinuation of Oral Anticoagulation After Pulmonary Vein Isolation in Patients With Atrial Fibrillation. JAMA Cardiol 2017; 2(2): 146-52.
[http://dx.doi.org/10.1001/jamacardio.2016.4179] [PMID: 27893055]
[107]
Schlingloff F, Oberhoffer M, Quasdorff I, Wohlmuth P, Schmoeckel M, Geidel S. Oral Anticoagulation After Successful Atrial Fibrillation Ablation Operations: Is It Necessary? Ann Thorac Surg 2016; 101(4): 1471-6.
[http://dx.doi.org/10.1016/j.athoracsur.2015.10.008] [PMID: 26627178]
[108]
Kim DH, Lee DI, Ahn J, et al. Ischemic stroke risk during long-term follow up in patients with successful catheter ablation for atrial fibrillation in Korea. PLoS One 2018; 13(7) e0201061
[http://dx.doi.org/10.1371/journal.pone.0201061] [PMID: 30024976]
[109]
Deng L, Xiao Y, Hong H. Withdrawal of oral anticoagulants 3 months after successful radiofrequency catheter ablation in patients with atrial fibrillation: A meta-analysis. Pacing Clin Electrophysiol 2018; 41(11): 1391-400.
[http://dx.doi.org/10.1111/pace.13494] [PMID: 30192009]
[110]
Proietti R, AlTurki A, Di Biase L, et al. Anticoagulation after catheter ablation of atrial fibrillation: An unnecessary evil? A systematic review and meta-analysis. J Cardiovasc Electrophysiol 2019; 30(4): 468-78.
[http://dx.doi.org/10.1111/jce.13822] [PMID: 30575175]
[111]
Verma A, Ha ACT, Kirchhof P, et al. The Optimal Anti-Coagulation for Enhanced-Risk Patients Post-Catheter Ablation for Atrial Fibrillation (OCEAN) trial. Am Heart J 2018; 197: 124-32.
[http://dx.doi.org/10.1016/j.ahj.2017.12.007] [PMID: 29447772]
[112]
Schulman S, Angerås U, Bergqvist D, Eriksson B, Lassen MR, Fisher W. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients. J Thromb Haemost 2010; 8(1): 202-4.
[http://dx.doi.org/10.1111/j.1538-7836.2009.03678.x] [PMID: 19878532]
[113]
Kaatz S, Ahmad D, Spyropoulos AC, Schulman S. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost 2015; 13(11): 2119-26.
[http://dx.doi.org/10.1111/jth.13140] [PMID: 26764429]
[114]
Ciconte G, Saviano M, Giannelli L, et al. Atrial fibrillation detection using a novel three-vector cardiac implantable monitor: the atrial fibrillation detect study. Europace 2017; 19(7): 1101-8.
[http://dx.doi.org/10.1093/europace/euw181] [PMID: 27702865]
[115]
Glotzer TV, Hellkamp AS, Zimmerman J, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST). Circulation 2003; 107(12): 1614-9.
[http://dx.doi.org/10.1161/01.CIR.0000057981.70380.45] [PMID: 12668495]
[116]
Brambatti M, Connolly SJ, Gold MR, et al. Temporal relationship between subclinical atrial fibrillation and embolic events. Circulation 2014; 129(21): 2094-9.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.113.007825] [PMID: 24633881]
[117]
Fassini G, Gasperetti A, Italiano G, et al. Cryoballoon pulmonary vein ablation and left atrial appendage closure combined procedure: A long-term follow-up analysis. Heart Rhythm 2019; 16(9): 1320-6.
[http://dx.doi.org/10.1016/j.hrthm.2019.03.022] [PMID: 30928784]
[118]
Di Biase L, Burkhardt JD, Mohanty P, et al. Left atrial appendage: an underrecognized trigger site of atrial fibrillation. Circulation 2010; 122(2): 109-18.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.928903] [PMID: 20606120]
[119]
Di Biase L, Burkhardt JD, Mohanty P, et al. Left Atrial Appendage Isolation in Patients With Longstanding Persistent AF Undergoing Catheter Ablation: BELIEF Trial. J Am Coll Cardiol 2016; 68(18): 1929-40.
[http://dx.doi.org/10.1016/j.jacc.2016.07.770] [PMID: 27788847]
[120]
Panikker S, Jarman JW, Virmani R, et al. Left Atrial Appendage Electrical Isolation and Concomitant Device Occlusion to Treat Persistent Atrial Fibrillation: A First-in-Human Safety, Feasibility, and Efficacy Study. Circ Arrhythm Electrophysiol 2016; 9(7)e003710
[http://dx.doi.org/10.1161/CIRCEP.115.003710] [PMID: 27406602]
[121]
Gadiyaram VK, Mohanty S, Gianni C, et al. Thromboembolic events and need for anticoagulation therapy following left atrial appendage occlusion in patients with electrical isolation of the appendage. J Cardiovasc Electrophysiol 2019; 30(4): 511-6.
[http://dx.doi.org/10.1111/jce.13838] [PMID: 30623500]
[122]
Klee K, Widulle D, Duckheim M, et al. Peri-interventional combined anticoagulation and antithrombotic therapy in atrial fibrillation ablation: A retrospective safety analysis. Cardiol J 2018; 25(2): 213-20.
[PMID: 28980285]
[123]
Cannon CP, Bhatt DL, Oldgren J, et al. Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. N Engl J Med 2017; 377(16): 1513-24.
[http://dx.doi.org/10.1056/NEJMoa1708454] [PMID: 28844193]
[124]
Lopes RD, Heizer G, Aronson R, et al. Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation. N Engl J Med 2019; 380(16): 1509-24.
[http://dx.doi.org/10.1056/NEJMoa1817083] [PMID: 30883055]
[125]
Gibson CM, Mehran R, Bode C, et al. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med 2016; 375(25): 2423-34.
[http://dx.doi.org/10.1056/NEJMoa1611594] [PMID: 27959713]
[126]
Kirchhof P, Haeusler KG, Blank B, et al. Apixaban in patients at risk of stroke undergoing atrial fibrillation ablation. Eur Heart J 2018; 39(32): 2942-55.
[http://dx.doi.org/10.1093/eurheartj/ehy176] [PMID: 29579168]
[127]
Cappato R, Marchlinski FE, Hohnloser SH, et al. Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial fibrillation. Eur Heart J 2015; 36(28): 1805-11.
[http://dx.doi.org/10.1093/eurheartj/ehv177] [PMID: 25975659]
[128]
Calkins H, Willems S, Gerstenfeld EP, et al. Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation. N Engl J Med 2017; 376(17): 1627-36.
[http://dx.doi.org/10.1056/NEJMoa1701005] [PMID: 28317415]
[129]
Di Biase L, Burkhardt JD, Santangeli P, et al. Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial fibrillation with different anticoagulation management: results from the Role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial. Circulation 2014; 129(25): 2638-44.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.113.006426] [PMID: 24744272]
[130]
Cardoso R, Knijnik L, Bhonsale A, et al. An updated meta-analysis of novel oral anticoagulants versus vitamin K antagonists for uninterrupted anticoagulation in atrial fibrillation catheter ablation. Heart Rhythm 2018; 15(1): 107-15.
[http://dx.doi.org/10.1016/j.hrthm.2017.09.011] [PMID: 28917562]
[131]
Hohnloser SH, Camm J, Cappato R, et al. Uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation: the ELIMINATE-AF trial. Eur Heart J 2019; 40(36): 3013-21.
[http://dx.doi.org/10.1093/eurheartj/ehz190] [PMID: 30976787]
[132]
Lickfett L, Hackenbroch M, Lewalter T, et al. Cerebral diffusion-weighted magnetic resonance imaging: a tool to monitor the thrombogenicity of left atrial catheter ablation. J Cardiovasc Electrophysiol 2006; 17(1): 1-7.
[PMID: 16426390]
[133]
Cardoso R, Willems S, Gerstenfeld EP, et al. Uninterrupted anticoagulation with non-vitamin K antagonist oral anticoagulants in atrial fibrillation catheter ablation: Lessons learned from randomized trials. Clin Cardiol 2019; 42(1): 198-205.
[http://dx.doi.org/10.1002/clc.23120] [PMID: 30460702]
[134]
Lip GYH, Banerjee A, Boriani G, et al. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report. Chest 2018; 154(5): 1121-201.
[http://dx.doi.org/10.1016/j.chest.2018.07.040] [PMID: 30144419]
[135]
Di Biase L, Burkhardt JD, Mohanty P, et al. Periprocedural stroke and management of major bleeding complications in patients undergoing catheter ablation of atrial fibrillation: the impact of periprocedural therapeutic international normalized ratio. Circulation 2010; 121(23): 2550-6.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.921320] [PMID: 20516376]
[136]
Wazni OM, Beheiry S, Fahmy T, et al. Atrial fibrillation ablation in patients with therapeutic international normalized ratio: comparison of strategies of anticoagulation management in the periprocedural period. Circulation 2007; 116(22): 2531-4.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.107.727784] [PMID: 17998456]
[137]
Schmidt M, Segerson NM, Marschang H, et al. Atrial fibrillation ablation in patients with therapeutic international normalized ratios. Pacing Clin Electrophysiol 2009; 32(8): 995-9.
[http://dx.doi.org/10.1111/j.1540-8159.2009.02429.x] [PMID: 19659617]
[138]
January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014; 130(23): 2071-104.
[http://dx.doi.org/10.1161/CIR.0000000000000040] [PMID: 24682348]
[139]
Robinson CG, Samson PP, Moore KMS, et al. Phase I/II Trial of Electrophysiology-Guided Noninvasive Cardiac Radioablation for Ventricular Tachycardia. Circulation 2019; 139(3): 313-21.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.118.038261] [PMID: 30586734]
[140]
Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J 2012; 33(12): 1500-10.
[http://dx.doi.org/10.1093/eurheartj/ehr488] [PMID: 22246443]

Rights & Permissions Print Cite
Article Metrics
33
4
© 2024 Bentham Science Publishers | Privacy Policy