title: Dabigatran in the peri-procedural period for radiofrequency ablation of atrial fibrillation: efficacy, safety, and impact on duration of hospital stay.
abstract: OBJECTIVE
  Dabigatran is effective for both the prevention of stroke and bleeding in patients with atrial fibrillation (AF). However, the safety and efficacy of the use of dabigatran in the peri-procedural period for radiofrequency catheter ablation (RFCA) of AF is unknown. Therefore, the purpose of this study was to evaluate the safety and efficacy of dabigatran in the peri-procedural period for RFCA of AF and the duration of hospital stay.
  
  
  METHODS
  Consecutive patients (n = 227) who underwent RFCA for AF were prospectively analyzed. Peri-procedural anticoagulant therapy with dabigatran (n = 101, D group) was compared with warfarin and heparin bridging (n = 126, W group). Dabigatran was discontinued 12-24 h before and restarted 3 h after the procedure. Warfarin was stopped 3 days before the procedure and unfractionated heparin was administered.
  
  
  RESULTS
  Ischemic stroke occurred in one patient of the D group (0.8 %). There was no significant difference between the two groups in the incidence of major bleeding (three cases of cardiac tamponade in each group and one case of intracranial bleeding in the W group, p = 0.93) or minor bleeding (five cases in the D group vs. five in the W group, p = 0.54). The duration of hospital stay was significantly shorter in the D group than in the W group (7.2 vs. 10.3 days, p = 0.0001).
  
  
  CONCLUSIONS
  Peri-procedural anticoagulation therapy with dabigatran for RFCA of AF was equally safe and effective compared with warfarin and heparin bridging. The use of dabigatran for RFCA of AF shortened the duration of hospital stay.
authors.affiliation: Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. dhaines@beaumont.edu
authors.forename: Kimitake
authors.initials: K
authors.lastname: Imamura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshida
authors.forename: Asumi
authors.initials: A
authors.lastname: Takei
authors.forename: Koji
authors.initials: K
authors.lastname: Fukuzawa
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kiuchi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takami
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Takami
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Itoh
authors.forename: Ryudo
authors.initials: R
authors.lastname: Fujiwara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yamashita
authors.forename: Akinori
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D000991:Antithrombins / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D001562:Benzimidazoles / Q000008:administration & dosage*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015897:Comorbidity; D000069604:Dabigatran; D003657:Decision Making; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011292:Premedication / Q000706:statistics & numerical data; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran