title: Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial fibrillation with different anticoagulation management: results from the Role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial.
abstract: BACKGROUND
  Periprocedural thromboembolic and hemorrhagic events are worrisome complications of catheter ablation for atrial fibrillation (AF). The periprocedural anticoagulation management could play a role in the incidence of these complications. Although ablation procedures performed without warfarin discontinuation seem to be associated with lower thromboembolic risk, no randomized study exists.
  
  
  RESULTS
  This was a prospective, open-label, randomized, parallel-group, multicenter study assessing the role of continuous warfarin therapy in preventing periprocedural thromboembolic and hemorrhagic events after radiofrequency catheter ablation. Patients with CHADS2 score ≥1 were included. Patients were randomly assigned in a 1:1 ratio to the off-warfarin or on-warfarin arm. The incidence of thromboembolic events in the 48 hours after ablation was the primary end point of the study. The study enrolled 1584 patients: 790 assigned to discontinue warfarin (group 1) and 794 assigned to continuous warfarin (group 2). No statistical difference in baseline characteristics was observed. There were 39 thromboembolic events (3.7% strokes [n=29] and 1.3% transient ischemic attacks [n=10]) in group 1: two events (0.87%) in patients with paroxysmal AF, 4 (2.3%) in patients with persistent AF, and 33 (8.5%) in patients with long-standing persistent AF. Only 2 strokes (0.25%) in patients with long-standing persistent AF were observed in group 2 (P<0.001). Warfarin discontinuation emerged as a strong predictor of periprocedural thromboembolism (odds ratio, 13; 95% confidence interval, 3.1-55.6; P<0.001).
  
  
  CONCLUSIONS
  This is the first randomized study showing that performing catheter ablation of AF without warfarin discontinuation reduces the occurrence of periprocedural stroke and minor bleeding complications compared with bridging with low-molecular-weight heparin.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT01006876.
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santangeli
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Prasant
authors.initials: P
authors.lastname: Mohanty
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sanchez
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Rodney
authors.initials: R
authors.lastname: Horton
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Sakis
authors.initials: S
authors.lastname: Themistoclakis
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Rossillo
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Steven
authors.initials: S
authors.lastname: Hao
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Richard
authors.initials: R
authors.lastname: Hongo
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Salwa
authors.initials: S
authors.lastname: Beheiry
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Jason
authors.initials: J
authors.lastname: Zagrodzky
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Bai
authors.initials: B
authors.lastname: Rong
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Sanghamitra
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Claude S
authors.initials: CS
authors.lastname: Elayi
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Giovanni
authors.initials: G
authors.lastname: Forleo
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Narducci
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Gaetano
authors.initials: G
authors.lastname: Fassini
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.).
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schweikert
authors.affiliation: From the Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (L.D.B., J.D.B., P.S., P.M., J.E.S., R. Horton, G.J.G., J.Z., B.R., S.M., A.N.); Albert Einstein College of Medicine, Montefiore Hospital, New York, NY (L.D.B.); Department of Biomedical Engineering, University of Texas, Austin (L.D.B., A.N.); Department of Cardiology, University of Foggia, Foggia, Italy (L.D.B., P.S.); Ospedale dell'Angelo, Mestre Venice, Italy (S.T., A.R.); University of Kansas, Kansas City (D.L., M.R.); California Pacific Medical Center, San Francisco (S.H., R. Hongo, S.B., A.N.); University of Kentucky, Lexington (C.S.E.); University of Tor Vergata, Rome, Italy (G. Forleo); University of Sacred Heart, Rome, Italy (G.P., M.L.N.); Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., G. Fassini, C.T.); Akron General Hospital, Akron, OH (R.A.S.); Division of Cardiology, Stanford University, CA (A.N.); Case Western Reserve University, Cleveland, OH (A.N.); and Interventional Electrophysiology, Scripps Clinic, La Jolla, CA (A.N.). dr.natale@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013923:Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*; D028761:Withholding Treatment
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: atrial fibrillation; catheter ablation; catheter ablation, radiofrequency; stroke; transient ischemic attack; warfarin