Periprocedural anticoagulation during left atrial ablation: interrupted and uninterrupted vitamin K-antagonists or uninterrupted novel anticoagulants

Brinkmeier-Theofanopoulou, Maria; Tzamalis, Panagiotis; Wehrkamp-Richter, Susan; Radzewitz, Andrea; Merkel, Matthias; Schymik, Gerhard; Mark, G.; Bramlage, Peter; Schmitt, Claus; Luik, Armin

doi:10.1186/s12872-018-0804-6

Cited by 7 publications

(2 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is classified based on the primary location of bleeding into intramedullary (haematomyelia), subarachnoid haemorrhage (SAH), subdural haemorrhage, and epidural haemorrhage. It requires emergency investigation and treatment 4 – 6 . Based on the existing literature spinal vascular malformations such as intradural arteriovenous malformations are the most common cause of atraumatic intramedullary spinal cord haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Acute fluctuating neurological deficits after pulmonary vein isolation: unmasking a rare complication due to spontaneous spinal subdural bleeding: a case report

Cioffi

Regoli

Conte

et al. 2019

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Pulmonary vein isolation (PVI) is becoming the therapy of choice for symptomatic paroxysmal drug-refractory atrial fibrillation (AF). The most frequently reported complications are vascular complications (1.4%). Bleeding complications of the central nervous system have rarely been described. We report a case of spontaneous spinal bleed after PVI. Case summary A 68-year-old woman with a 2-year history of highly symptomatic paroxysmal AF (EHRA 3) was referred for a PVI redo procedure. A high-density mapping showed pulmonary vein reconnection of all pulmonary veins successfully isolated by radiofrequency ablation. During the entire procedure, the patient had sinus rhythm with an ACT around 300 s. No intraprocedural and peri-procedural complications occurred. Four hours after haemostasis, the anticoagulation clotting time (ACT) was 110 s and rivaroxaban (20 mg) was reinitiated. In the following hours, the patient developed fluctuating neurological lower limb symptoms. A lumbar magnetic resonance imaging showed a subdural spinal haematic collection with an associated epidural component from L3 to S2 exerting compression over the dural sheath. A conservative treatment approach was adopted with progressive recovery of sensorial and motor deficits. After 5 months, the patient still presented residual lower limb motor deficits necessitating the support of a walking stick. Discussion We describe the first case of a spontaneous spinal bleeding following PVI. Given the gradual diffusion of PVI to treat AF in more clinically complex patients with a larger range of comorbidities, particular consideration should be given to seek predisposing bleeding factors in order to assess the risk for neurological complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute fluctuating neurological deficits after pulmonary vein isolation: unmasking a rare complication due to spontaneous spinal subdural bleeding: a case report

Cioffi

Regoli

Conte

et al. 2019

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

“…Одно тромбоэмболическое осложнение произошло в группе варфарина, в группе дабигатрана -не отмечалось. У больных, получавших дабигатран, достоверно реже случались большие кровотечения 1,4% по сравнению с 5% в группе варфарина (р = 0,03) [16].…”

Section: антикоагулянтная терапии во время и после проведения катетерunclassified

Aspects of anticoagulant therapy in patients with atrial fibrillation in the light of updated guidelines of the European society of cardiology 2020: the position of dabigatran

Кропачева

Панченко

2020

Aterotromboz

View full text Add to dashboard Cite

This review focuses on some aspects of anticoagulant therapy in the updated clinical guidelines for atrial fibrillation of the European society of cardiology, published in 2020. Atrial fibrillation is a polymorbid continuously developing syndrome, and therefore the treatment strategy is based on a comprehensive assessment of the patient, including the risk of stroke, the presence and severity of symptoms, and an assessment of structural heart disease and comorbidities. The review describes the principles of the proposed integrated approach, abbreviated “ABC pathway”, as reflecting the three main directions of the treatment strategy. According to experts, the clinical picture of AF (i.e. first detected, paroxysmal, persistent, long-term persistent or permanent) should not determine the indications for the appointment of anticoagulant therapy. The CHA2DS2-VASc scale continues to be the basis for stratification of thromboembolic risk. The role of dabigatran in primary and secondary prevention of stroke and systemic embolism in patients with atrial fibrillation is described. Changes in the position of experts regarding the assessment of bleeding risk are highlighted in order to help identify unmodified and eliminate modifiable risk factors for bleeding, as well as to identify AF patients who are potentially at high risk of bleeding for more frequent monitoring and monitoring of their condition. Questions about the use of direct oral anticoagulants in the choice of rhythm control tactics are highlighted separately. The use of dabigatran in patients undergoing cardioversion and catheter ablation is justified. Practical questions about the continuous strategy of anticoagulant therapy during ablation are highlighted separately. Changes related to multicomponent therapy after percutaneous coronary intervention are highlighted. The main measure to improve the safety of combined antithrombotic therapy is to minimize the duration of triple therapy. The updated recommendations supportlimiting the duration of triple antithrombotic therapy to 1 month, and also provide for early discontinuation of aspirin (≤1 week) and continuation of double antithrombotic therapy in cases of uncomplicated stenting and low risk of thrombosis, or when the risk of bleeding exceeds the risk of thrombotic events.

show abstract

Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias

Bawazeer

Alkofide

Alsharafi

et al. 2021

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Periprocedural anticoagulation during left atrial ablation: interrupted and uninterrupted vitamin K-antagonists or uninterrupted novel anticoagulants

Cited by 7 publications

References 21 publications

Acute fluctuating neurological deficits after pulmonary vein isolation: unmasking a rare complication due to spontaneous spinal subdural bleeding: a case report

Acute fluctuating neurological deficits after pulmonary vein isolation: unmasking a rare complication due to spontaneous spinal subdural bleeding: a case report

Aspects of anticoagulant therapy in patients with atrial fibrillation in the light of updated guidelines of the European society of cardiology 2020: the position of dabigatran

Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias

Contact Info

Product

Resources

About