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Updated: Apr 19, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Comparison of outcomes after cardioversion or atrial fibrillation ablation in patients with differing periprocedural
Simon Kochhäuser1, Yaariv Khaykin1, Jessica Beardsall1
1Southlake Regional Health Centre, Newmarket, Ontario, Canada.
Insights
This study compared warfarin, dabigatran, and rivaroxaban for atrial fibrillation procedures. All anticoagulants showed low adverse events, indicating they are safe options for cardioversion and ablation.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Limited data exist comparing traditional vitamin K antagonists (VKA) with novel oral anticoagulants for periprocedural management of atrial fibrillation (AF) interventions.
- This study addresses the gap by comparing outcomes of VKA, dabigatran, and rivaroxaban in patients undergoing cardioversion or ablation for AF.
Purpose of the Study:
- To compare the safety and efficacy of warfarin (VKA), dabigatran (DABI), and rivaroxaban (RIVA) in the periprocedural management of cardioversion or ablation in patients with atrial fibrillation (AF).
Main Methods:
- A consecutive series of patients undergoing cardioversion or ablation for AF between October 2010 and October 2013 were analyzed.
- Patients were divided into three anticoagulation groups: warfarin (VKA), dabigatran (DABI), and rivaroxaban (RIVA).
- Safety outcomes included stroke, transient ischemic attack (TIA), and clinically significant bleeding events.
Main Results:
- For cardioversion (n=901), no strokes occurred; TIAs were infrequent (2 in DABI group). Bleeding rates were low and similar across VKA, DABI, and RIVA groups.
- For ablation (n=680), no strokes occurred; TIAs were infrequent (2 in VKA, 1 in DABI group). Bleeding rates were low and not significantly different among the three anticoagulation regimens.
- Baseline characteristics were well-balanced, and average follow-up was 6 months.
Conclusions:
- All evaluated anticoagulation regimens (warfarin, dabigatran, rivaroxaban) demonstrated a low incidence of adverse events.
- These anticoagulants are safe and viable options for periprocedural management in patients undergoing cardioversion or ablation for atrial fibrillation.
Background:
There is a paucity of data that compare traditional vitamin K antagonist (VKA) with novel oral anticoagulant regimens in periprocedural management of cardioversion or ablation of atrial fibrillation (AF). We sought to compare outcomes of use of VKA, dabigatran (DABI), and rivaroxaban (RIVA) anticoagulation around the time of intervention.
Methods:
We studied consecutive patients undergoing cardioversion or ablation of AF at our centre from October 2010 to October 2013. There were 3 different anticoagulation groups: warfarin (VKA), DABI, and RIVA. Safety was assessed according to number of strokes, transient ischemic attacks (TIAs), and clinically important and not important bleeding events.
Results:
Baseline characteristics were well balanced between the groups. Average follow-up was 6 months (± 4 months). A total of 901 patients who underwent cardioversion were studied (VKA [n = 471], DABI [n = 288] and RIVA [n = 141]). In these patients there were no strokes seen during follow-up and 2 TIAs in the DABI group. Bleeding rates were low, with no significant difference between the 3 groups. A total of 680 patients who underwent ablation were studied (VKA [n = 319], DABI [n = 220] and RIVA [n = 171]). There were no strokes reported during follow-up and 3 TIAs: 2 in the VKA group and 1 in the DABI group not resulting in a significant difference between the groups. Bleeding rates were low, with no significant difference between the groups.
Conclusions:
Overall, there was a low incidence of adverse events for all anticoagulation regimens. Warfarin, DABI, and RIVA use around the time of the procedure are safe and reasonable options for patients who undergo cardioversion or AF ablation.
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