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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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[S1 guideline - Austrian consensus for anticoagulation in the context of atrial fibrillation ablation]

Martin Martinek1, Marianne Gwechenberger2, Daniel Scherr3

  • 1Abteilung für Innere Medizin 2 mit Kardiologie, Angiologie und Internistischer Intensivmedizin, Ordensklinikum Linz, Elisabethinen, Fadingerstraße 1, 4020, Linz, Österreich.

Wiener Klinische Wochenschrift
|January 27, 2018
PubMed

Insights

Uninterrupted oral anticoagulation (OAK) is recommended for patients undergoing periprocedural ventricular intervention (PVI), avoiding heparin bridging to minimize bleeding risks. This consensus aims to enhance patient safety and standardize OAK approaches in Austria.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Atrial fibrillation management requires careful consideration of anticoagulation during procedures.
  • Existing guidelines offer varying recommendations for oral anticoagulation (OAK) during periprocedural ventricular intervention (PVI).
  • The CHA2DS2-VASc score influences anticoagulation decisions, even in low-risk patients.

Framework:

  • This consensus provides evidence-based recommendations for oral anticoagulation (OAK) in the context of periprocedural ventricular intervention (PVI).
  • Recommendations cover both Vitamin K antagonist (VKA) and novel oral anticoagulant (NOAC) therapies.
  • The guideline emphasizes uninterrupted OAK, recommending its continuation 3-4 weeks before and 8 weeks after PVI.

Implementation:

  • Periinterventional bridging with heparins is strongly discouraged due to an increased risk of bleeding events.
  • The consensus was developed by experienced members of the Rhythmology Working Group of the Austrian Cardiological Society.
  • Practical experience in catheter ablation and peri-interventional OAK in atrial fibrillation patients informed the recommendations.

Implications:

  • The guideline aims to enhance patient safety during PVI by standardizing anticoagulation management.
  • It promotes a homogeneous approach to peri-interventional oral anticoagulation (OAK) for physicians in Austria.
  • Future updates are anticipated as new randomized controlled studies emerge, ensuring the guideline remains current.

Keywords:
AblationAtrial fibrillationConsensusNon-vitamin k oral anticoagulants (NOAC)Vitamin K antagonists (VKA)

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