Comparison of Interrupted and Uninterrupted Anticoagulation Therapy for Patients With Atrial Fibrillation Undergoing Catheter Ablation: A Meta-Analysis

Abstract

Adequate periprocedural anticoagulation is important to prevent complications like transient ischemic attack, stroke, severe esophageal injury, and pulmonary vein stenosis. The aim of this meta-analysis was to compare uninterrupted anticoagulation therapy with interrupted anticoagulation therapy for patients with arrhythmias undergoing catheter ablation. The current meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several online databases were searched, such as PubMed, Cochrane Library, and Embase, to search for relevant randomized controlled trials (RCTs). The primary outcome included thromboembolic events. Secondary outcomes included major bleeding events and minor bleeding events. A total of eight RCTs were included in the current metaanalysis, encompassing a total of 3893 patients. No significant differences were reported in relation to thromboembolic events (RR: 2.39, 95% CI: 0.41-13.97, p-value: 0.33), major bleeding events (RR: 0.99, 95% CI: 0.50-1.96, p-value: 0.98) and minor bleeding events (RR: 1.55, 95% CI: 0.56-4.30, p-value: 0.40) between the two study groups. This meta-analysis did not find any conclusive evidence for the absence of any difference between the two strategies.

Comparison of short-term efficacy of two bipolar radiofrequency ablation forceps for rheumatic heart disease concomitant with atrial fibrillation

“…In addition, the higher disability and mortality rates due to stroke in AF are a major global problem, and in particular, the risk of stroke is tripled in combination with RHD ( 1 ). Rhythm-control-based pharmacotherapy and catheter ablation were earlier proposed for the treatment of AF with the aim of preventing stroke, controlling heart rate, reducing symptoms, and improving the cardiac function and quality of life of patients ( 10 – 12 ). Unfortunately, drug therapy generally has serious side effects, and the stable maintenance of SR after catheter ablation often requires multiple ablations, both of which have not significantly improved patients’ left heart function and quality of life ( 13 ).…”

“…Zhang et al 10.3389/fcvm.2024.1335407 about 1 min to produce an ablation radius of 3-6 mm in depth, which is sufficient to achieve the required transmural effect for cardiac conduction block (20,21). At present, it is not possible to say which of the two ablation forceps is superior in terms of wall penetration integrity, as there is no clear evidence that the created ablation trails completely block electrical conduction, and the surgeon's skill and left atrial size may affect wall penetration, which can only be assessed indirectly on the basis of the appropriate parameters.…”