title: Usefulness of dabigatran etexilate as periprocedural anticoagulation therapy for atrial fibrillation ablation.
abstract: BACKGROUND
  The usefulness of dabigatran etexilate for the prevention of stroke in patients with atrial fibrillation (AF) has been reported.
  
  
  OBJECTIVE
  In this study the efficacy and safety of dabigatran etexilate for anticoagulation for AF ablation were examined.
  
  
  METHODS
  Patients were divided into three groups: Group 1, interrupted warfarin bridged by heparin between pre- and post-ablation; Group 2, continuous warfarin therapy; and Group 3, dabigatran etexilate therapy. Anticoagulation therapy with warfarin or dabigatran etexilate was performed from 30 days before to at least 90 days after AF ablation. Dabigatran etexilate was administered at 110 or 150 mg twice daily, depending on renal function and age.
  
  
  RESULTS
  Patients' clinical characteristics, associated disorders, echocardiographic parameters and arrhythmia status were not different among the three groups. Procedural parameters such as procedural time and radiofrequency energy supply were also not different among the three groups. The dabigatran etexilate group and the warfarin groups had no embolic complications (stroke, cerebral transient ischaemic attack, deep venous thrombosis or pulmonary embolism). No pericardial tamponade was observed in the dabigatran etexilate group, while two patients in each of Group 1 (2/194, 1.0 %) and Group 2 (2/203, 0.98 %) developed cardiac tamponade, though the differences were not significant. Pericardial effusion and groin haematoma were observed in one patient each (1/105, 0.9 %) in the dabigatran etexilate group, and the incidences were not different from the warfarin group (Group 1: 4/194, 2.1 % and 2/194, 1.0 %; Group 2: 3/203, 1.5 % and 2/203, 1.0 %, respectively). As a whole, the safety outcomes did not differ among the three groups.
  
  
  CONCLUSIONS
  Dabigatran etexilate is an effective and safe anticoagulation therapy for AF ablation. Thus, dabigatran etexilate appears to be useful as an alternative anticoagulant therapy to warfarin for AF ablation.
authors.affiliation: Okayama Heart Clinic, Okayama, Japan.
authors.forename: Hirosuke
authors.initials: H
authors.lastname: Yamaji
authors.forename: Takashi
authors.initials: T
authors.lastname: Murakami
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Hina
authors.forename: Shunichi
authors.initials: S
authors.lastname: Higashiya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Murakami
authors.forename: Shigeshi
authors.initials: S
authors.lastname: Kamikawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirohata
authors.forename: Shozo
authors.initials: S
authors.lastname: Kusachi
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods*; D000069604:Dabigatran; D004305:Dose-Response Relationship, Drug; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D011725:Pyridines; D014859:Warfarin; D006493:Heparin; D000069604:Dabigatran