title: Post-Procedural Dabigatran Versus Interrupted Warfarin Therapy Following Catheter Ablation for Atrial Fibrillation.
abstract: OBJECTIVE
  Patients undergoing catheter ablation for atrial fibrillation (AF) are at a higher risk of thromboembolic events post-procedure and therefore require therapeutic anticoagulation after ablation. Anticoagulation strategies include performing the procedure on or off therapeutic warfarin, though the latter approach requires post-procedure bridging therapy with low molecular-weight heparin (LMWH) until a therapeutic INR is achieved. The purpose of this study is to compare the safety and efficacy of post-ablation dabigatran as compared to warfarin with LMWH bridging.
  
  
  METHODS
  We performed a single-center retrospective analysis of consecutive patients who underwent catheter ablation for AF between January 2010 and December 2012 and received either post-procedure warfarin with a LMWH bridge or dabigatran. Warfarin was started the night of ablation; LMWH was started the next morning and continued until the INR was ≥ 2.0. Dabigatran was started the morning post-ablation.
  
  
  RESULTS
  The analysis included 324 patients. Of these, mean age was 60 ± 9 years, 78% were male, 81% had CHADS2scores of 0 or 1, and 181 (56%) received dabigatran post-ablation. Patients who received dabigatran had lower CHADS2scores and were more likely to be in NYHA Class I. At 30-days post-procedure, there were 0 thromboembolic or bleeding complications in the dabigatran group versus 4 (2.8%) in the warfarin group (p=0.037). There were no deaths in either group at 30 days post-ablation.
  
  
  CONCLUSIONS
  Post-ablation dabigatran appears safe and efficacious compared to an interrupted warfarin strategy with LMWH bridging.
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lin Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Sharon
authors.initials: S
authors.lastname: Shen Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Prashant
authors.initials: P
authors.lastname: Bhave Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Bradley
authors.initials: B
authors.lastname: Knight Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Martha
authors.initials: M
authors.lastname: Bohn Rn Bsn
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Evaldas
authors.initials: E
authors.lastname: Giedrimas Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Taral
authors.initials: T
authors.lastname: K Patel Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Chicos Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Goldberger Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Leonard
authors.initials: L
authors.lastname: Ilkhanoff Md Ms
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Susan
authors.initials: S
authors.lastname: Kim Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Albert
authors.initials: A
authors.lastname: Lin Md
authors.affiliation: Department of Medicine, Division of Cardiology,Bluhm Cardiovascular Institute. Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Rod
authors.initials: R
authors.lastname: Passman Md Msce
keywords: Anticoagulation; Atrial Fibrillation Ablation; Dabigatran; Warfarin