Management and outcomes of cardiac tamponade during atrial fibrillation ablation in the presence of therapeutic anticoagulation with warfarin

Latchamsetty, Rakesh; Gautam, Sandeep; Bhakta, Deepak; Chugh, Aman; John, Roy M.; Epstein, Laurence M.; Miller, John M.; Michaud, Gregory F.; Oral, Hakan; Morady, Fred; Jongnarangsin, Krit

doi:10.1016/j.hrthm.2011.01.020

Cited by 56 publications

(30 citation statements)

References 8 publications

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“…No difference was observed in the initial pericardial drainage, or the duration of drainage; no patients required surgery. 1137 A more recent shift in periprocedural anticoagulation strategies during AF ablation involves performing AF ablation on uninterrupted NOAC therapy. The results of the RE-CIRCUIT study, which was a head-to-head comparison of performing AF ablation on uninterrupted dabigatran vs uninterrupted warfarin, were recently published.…”

Section: Section 10: Complicationsmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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Section: Section 10: Complicationsmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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1,760

1,468

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“…[1][2][3] Several studies have shown that the periprocedural continuation of therapeutic warfarin could reduce thromboembolic complications without increasing the risk of hemorrhagic complications. [4][5][6][7][8][9] In addition, it has been reported that cardiac tamponade as a complication of AF ablation is not difficult to manage when the procedure is performed under therapeutic international normalized ratio (INR). 9 …”

mentioning

confidence: 99%

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

Kaseno

Naito

Nakamura

et al. 2012

Circ J

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“…If the bleeding continues, a second injection of protamine sulfate can be given; this dose of protamine sulfate should be half that of the first. 14) Management of urgent reversal of the effect of warfarin should be individualized and depends on the severity of the hemorrhage and the INR value when bleeding occurs. 15) Vitamin K is a useful agent for reversing supratherapeutic INR in patients who have active bleeding or require invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

Periprocedural Anticoagulation of Patients Undergoing Pericardiocentesis for Cardiac Tamponade Complicating Catheter Ablation of Atrial Fibrillation

et al. 2015

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SummaryAnticoagulation of patients with cardiac tamponade (CT) complicating catheter ablation of atrial fibrillation (AF) is an ongoing problem. The aim of this study was to survey the clinical practice of periprocedural anticoagulation in such patients. This study analyzed the periprocedural anticoagulation of 17 patients with CT complicating AF ablation. Emergent pericardiocentesis was performed once CT was confirmed. The mean drained volume was 410.0 ± 194.1 mL. Protamine sulfate was administered to neutralize heparin (1 mg neutralizes 100 units heparin) in 11 patients with persistent pericardial bleeding and vitamin K1 (10 mg) was given to reverse warfarin in 3 patients with supratherapeutic INR (INR > 2.1). Drainage catheters were removed 12 hours after echocardiography confirmed absence of intrapericardial bleeding and anticoagulation therapy was restored 12 hours after removing the catheter. Fifteen patients took oral warfarin and 10 of them were given subcutaneous injection of LMWH (1 mg/kg, twice daily) as a bridge to resumption of systemic anticoagulation with warfarin. Two patients with a small amount of persistent pericardial effusion were given LMWH on days 5 and 13, and warfarin on days 6 and 24. The dosage of warfarin was adjusted to keep the INR within 2-3 in all patients. After 12 months of follow-up, all patients had no neurological events and no occurrence of delayed CT. The results showed that it was effective and safe to resume anticoagulation therapy 12 hours after removal of the drainage catheter. This may help to prevent thromboembolic events following catheter ablation of AF. (Int Heart J 2015; 56: 56-61)

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Management and outcomes of cardiac tamponade during atrial fibrillation ablation in the presence of therapeutic anticoagulation with warfarin

Cited by 56 publications

References 8 publications

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

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

Periprocedural Anticoagulation of Patients Undergoing Pericardiocentesis for Cardiac Tamponade Complicating Catheter Ablation of Atrial Fibrillation

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