Author + information
- Received January 8, 2018
- Revision received February 15, 2018
- Accepted February 16, 2018
- Published online May 21, 2018.
- Satoshi Yanagisawa, MD, PhDa,∗ (, )
- Yasuya Inden, MD, PhDb,
- Aya Fujii, MDb,
- Monami Ando, MDb,
- Junya Funabiki, MDb,
- Yosuke Murase, MDb,
- Masaki Takenaka, MDb,
- Noriaki Otake, MDb,
- Yoshihiro Ikai, MDb,
- Yusuke Sakamoto, MDb,
- Rei Shibata, MD, PhDa and
- Toyoaki Murohara, MD, PhDb
- aDepartment of Advanced Cardiovascular Therapeutics, Nagoya University Graduate School of Medicine, Nagoya, Japan
- bDepartment of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- ↵∗Address for correspondence:
Dr. Satoshi Yanagisawa, Department of Advanced Cardiovascular Therapeutics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan.
Objectives The goal of this study was to evaluate the efficacy and safety of uninterrupted direct oral anticoagulant (DOAC) use and uninterrupted warfarin administration in elderly patients undergoing catheter ablation for atrial fibrillation (AF).
Background There is limited knowledge regarding the uninterrupted use of oral anticoagulant agents in elderly patients undergoing catheter ablation for AF.
Methods This retrospective study included 2,164 patients (n = 325 ≥75 years of age and n = 1,839 <75 years of age) who underwent catheter ablation for AF. All the patients received uninterrupted oral anticoagulant agents during the procedure. We investigated the occurrences of periprocedural events and compared these between the DOAC and warfarin groups of the elderly and younger groups.
Results Major bleeding events (3.1% vs. 1.3%; p = 0.023) and minor bleeding events (9.2% vs. 5.0%; p = 0.002), except for thromboembolic events (0% vs. 0.8%; p = 0.248), were significantly higher in the elderly group than in the younger group. No significant differences in thromboembolic and bleeding events were found between the DOAC and warfarin groups of both the elderly and younger groups. Adverse complications did not differ between the groups after adjustment using propensity score matching analysis. Multivariate analysis revealed that lower body weight (odds ratio: 0.96; p = 0.010) and antiplatelet drug use (odds ratio: 2.21; p = 0.039) were independent predictors of adverse events in the elderly group.
Conclusions The periprocedural bleeding risk during the use of uninterrupted oral anticoagulants was higher in the elderly group than in the younger group. This area needs more attention for these patients in whom caution is required.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received January 8, 2018.
- Revision received February 15, 2018.
- Accepted February 16, 2018.
- 2018 The Authors