Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation

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概要

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• Background: Periprocedural anticoagulation using uninterrupted warfarin could reduce the risk of thromboembolic complications of atrial fibrillation (AF) ablation. Few studies, however, have evaluated the efficacy and safety of periprocedural dabigatran in AF ablation. Methods and Results: A total of 211 consecutive patients who underwent AF ablation, including 110 patients who received 110mg dabigatran twice daily (group D) and 101 patients who received dose-adjusted warfarin (international normalized ratio, 2.0–3.0; group W), were evaluated. Dabigatran was discontinued on the morning of the procedure, and resumed on the next morning. Warfarin was continued throughout the procedure. During the procedure, heparin infusion was maintained to achieve an activated clotting time of >300s. Postprocedural cerebral magnetic resonance imaging (MRI) was performed in 60 patients (group D, n=31; group W, n=29). No periprocedural deaths or symptomatic thromboembolic complications were observed in either group. MRI indicated a silent cerebral infarction in 1 patient in each group. Five patients in group D and 11 in group W had minor bleeding (P=0.12). Cardiac tamponade occurred in 2 patients in group W, but in none in group D. Total bleeding complications occurred less frequently in group D (4.5%) than in group W (12.9%; P<0.05). Conclusions: Dabigatran at a dose of 110mg twice daily was safe for AF ablation in patients with a relatively low risk of thromboemboli, suggesting that it may become an alternative to warfarin in those patients.  (Circ J 2012; 76: 2337–2342)

• 2012-09-25

著者

• 内藤 滋人

  Division Of Cardiology Takarazuka Hospital

• Tada Hiroshi

  Cardiology Department of Internal Medicine, Univercity of Tsukuba Graduate School of Comprehensive H

• Oshima S

  Department Of Cardiology Gunma Prefectural Cardiovascular Center

• 内藤 滋人

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• 夛田 浩

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Kusano Kengo

  Dep. Of Cardiovascular Medicine Graduate School Of Medicine Dentistry And Pharmaceutical Sciences Ok

• Kato Kenichi

  横浜労災病院 循環器科

• Horinouchi T

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Yamashita Eiji

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• KASENO Kenichi

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• Naito Shigeto

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Naito Shigeto

  The Second Department Of Internal Medicine And The Department Of Hygiene Gunma University School Of

• Naitou Shigeto

  Department Of Cardiology Gunma Prefectural Cardiovascular Center

• Hatori Takashi

  Internal Medicine Kitakanto Cardiovascular Hospital

• Mikami Yoko

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Katoh Kenichi

  Yokohama Rosai Hospital

• Oshima Shigeru

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• SASAKI Takehito

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• FUKE Etsuko

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• SAKAMOTO Tamotsu

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• Fuke Etsuko

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Nakamura K

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Hatori Takashi

  Department Of Cardiovascular Science And Medicine Chiba University Graduate School Of Medicine

• Mikami Yuji

  Department Of Cardiovascular Science And Medicine Chiba University

• Mikami Ynji

  Department Of Cardiovascular Science And Medicine Chiba University Graduate School Of Medicine

• Yamashita Eiji

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Shibazaki Taro

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Kumagai Koji

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Oshima Shigeru

  Divisions Of Cardiology Gunma Prefectural Cardiovascular Center

• Ohshima Shigeru

  Gunma Prefectural Cardiovascular Center

• Nakamura Kohki

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Nakamura Kazufumi

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Takaoka Hiroyuki

  Department Of Cardiovascular Science And Medicine Chiba Univeristy School Of Medicine

• Hashimoto Takafumi

  Department Of Cardiology Musashino Red Cross Hospital

• Takamatsu Hiroto

  Division Of Cardiology Fujioka General Hospital

• Sakamoto Tamotsu

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Tada Hiroshi

  Division Of Cardiology Fujioka General Hospital

• Kumagai Naoko

  Department Of Cardiovascular Medicine Okayama University Graduate School Of Medicine Dentistry And P

• Nakamura Kazufumi

  Department Of Cardiovascular Medicine Okayama University Graduate School Of Medicine Dentistry And P

• Miki Yuko

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Tada Hiroshi

  Cardiovascular Division Institute Of Clinical Medicine Graduate School Of Comprehensive Human Scienc

• Nakahawa Koji

  Department Of Cardiology Okayama University

• Haga Takaaki

  Department Of Cardiology And Cardiovascular Surgery Shinkyo Hospital

• Katoh Kennichi

  Cardiovascular Center Toranomon Hospital

• Hayano Mamoru

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• TSUKADA Naofumi

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• NISHIUCHI Suguru

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• NAKAMURA Keijiro

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

• Nishiuchi Suguru

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Tsukada Naofumi

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• 大島 茂

  Division of Cardiology, Gunma Prefectural Cardiovascular Center

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