title: Safety And Efficacy Of Uninterrupted Periprocedural Apixaban In Patients Undergoing Atrial Fibrillation Catheter Ablation: A Metaanalysis Of 1,057 Patients.
abstract: Apixaban (factor Xa inhibitor) is a novel anticoagulant and may be beneficial during atrial fibrillation (AF) ablation for prevention of thromboembolic events. However, the adverse effects of periprocedural apixaban therapy have not been thoroughly evaluated. A meta-analysis was performed to evaluate the safety of apixaban for anticoagulation in AF ablation. We searched the online databases till October 2015 for studies comparing Apixaban with Vitamin K antagonists in atrial fibrillation patients undergoing catheter ablation. Primary outcome of our study was composite of thromboembolic event and bleeding (includes major and minor bleeding). A total of 1,057 atrial fibrillation patients in 3 studies undergoing catheter ablation were included in this analysis. Zero thromboembolic events were reported in the apixaban group and 1 in the VKA group with no statistical difference (OR 0.75; 95% CI 0.03-18.49). No major differences were observed for the primary outcome (OR 0.92; 95% CI 0.54-1.55), risk of overall bleeding (OR 0.94, 95% CI 0.55- 1.58), major bleeding (OR1.37; 95% CI 0.33-5.67), minor bleeding (OR 0.89; 95% CI 0.50-1.55), pericardial effusion (OR 0.50; 95% CI 0.18-1.38) and groin hematoma (OR 1.36; 95% CI 0.70-2.65). Uninterrupted apixaban administration in patients undergoing AF catheter ablation was non-inferior to VKA without increasing the risk of major and minor bleeding.
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA.
authors.forename: Jalaj
authors.initials: J
authors.lastname: Garg
authors.affiliation: Department of Medicine, Sinai Hospital of Baltimore, Johns Hopkins University, Baltimore, MD.
authors.forename: Rahul
authors.initials: R
authors.lastname: Chaudhary
authors.affiliation: Department of Medicine, Division of Cardiology, Einstein Healthcare Network, Philadelphia, PA.
authors.forename: Parasuram
authors.initials: P
authors.lastname: Krishnamoorthy
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Shah
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA.
authors.forename: Babak
authors.initials: B
authors.lastname: Bozorgnia
authors.affiliation: Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
keywords: Anticoagulation; Apixaban; Atrial Fibrillation Ablation; Complications