INSTRUCTION: Preablation transesophageal echocardiography (TEE) is dispensable for the patients with planned catheter ablation for atrial fibrillation (AF) and having received at least a 3-week oral anticoagulation therapy according to the recommendations of the Venice Consensus. But the role of prior TEE and the effect of preablation short-term oral anticoagulation drugs (OACs) under the circumstance are still unclear. METHODS AND RESULTS: A total of 188 patients with planned catheter ablation for AF and without previous long-term oral anticoagulation, whose duration of AF exceeded 48 h, were randomly divided into receiving 3-week OACs (OACs group) before heparin bridging or receiving no prior OACs (N-OACs group). Follow-up was performed until a TEE had been performed on all the cases before ablation. Consequently, the prevalence of atrial thrombi is 6.3% and 11.7%, respectively (P < 0.05), and the prevalence of minor bleeding is 5.3% and 0%, respectively (P < 0.05), in OACs and N-OACs group. There was no thrombotic event, major hemorrhage, in both groups. CONCLUSION: After a 3-week effective oral anticoagulation, atrial thrombi could be resolved partly but not completely in the patients with AF who had not received long-term oral anticoagulation previously. To ensure safety, prior TEE may be necessary for the patients with planned catheter ablation for AF.
RCT Entities:
INSTRUCTION: Preablation transesophageal echocardiography (TEE) is dispensable for the patients with planned catheter ablation for atrial fibrillation (AF) and having received at least a 3-week oral anticoagulation therapy according to the recommendations of the Venice Consensus. But the role of prior TEE and the effect of preablation short-term oral anticoagulation drugs (OACs) under the circumstance are still unclear. METHODS AND RESULTS: A total of 188 patients with planned catheter ablation for AF and without previous long-term oral anticoagulation, whose duration of AF exceeded 48 h, were randomly divided into receiving 3-week OACs (OACs group) before heparin bridging or receiving no prior OACs (N-OACs group). Follow-up was performed until a TEE had been performed on all the cases before ablation. Consequently, the prevalence of atrial thrombi is 6.3% and 11.7%, respectively (P < 0.05), and the prevalence of minor bleeding is 5.3% and 0%, respectively (P < 0.05), in OACs and N-OACs group. There was no thrombotic event, major hemorrhage, in both groups. CONCLUSION: After a 3-week effective oral anticoagulation, atrial thrombi could be resolved partly but not completely in the patients with AF who had not received long-term oral anticoagulation previously. To ensure safety, prior TEE may be necessary for the patients with planned catheter ablation for AF.
Authors: Hakan Oral; Carlo Pappone; Aman Chugh; Eric Good; Frank Bogun; Frank Pelosi; Eric R Bates; Michael H Lehmann; Gabriele Vicedomini; Giuseppe Augello; Eustachio Agricola; Simone Sala; Vincenzo Santinelli; Fred Morady Journal: N Engl J Med Date: 2006-03-02 Impact factor: 91.245
Authors: G Palareti; N Leali; S Coccheri; M Poggi; C Manotti; A D'Angelo; V Pengo; N Erba; M Moia; N Ciavarella; G Devoto; M Berrettini; S Musolesi Journal: Lancet Date: 1996-08-17 Impact factor: 79.321
Authors: Allan L Klein; R Daniel Murray; Edmund R Becker; Steven D Culler; William S Weintraub; Susan E Jasper; Elizabeth A Lieber; Carolyn Apperson-Hansen; Adrienne M Heerey; Richard A Grimm Journal: J Am Coll Cardiol Date: 2004-04-07 Impact factor: 24.094