Ronghui Yu1, Hui Xi2, Jun Lu3, Fengqiang Xu3, Lisheng Shi4, Qiang Kong4, Yucai Hu5, Xin Zhao6, Nian Liu6. 1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China. ronghuiyu20@163.com. 2. Department of Cardiology, Peking University International Hospital, Beijing 102206, China. 3. Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China. 4. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. 5. The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China. 6. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China.
Abstract
BACKGROUND: To find out the real-world investigation on discontinuation of oral anticoagulation after paroxysmal atrial fibrillation (AF) catheter ablation China. METHODS: We enrolled in our study 1,508 consecutive paroxysmal AF patients who underwent catheter ablation from five centers. Patients' clinical data and follow-up data were collected. Clinical data included on-admission characteristics such as gender, age, type and duration of AF, type of ablation, ablation sessions, history of diseases, CHA2DS2-VASc score, echocardiographic variables, medication, and blood test variables. Follow-up data included duration of follow-up, the status of oral anticoagulant (OAC) therapy, adverse events, and recurrence of AF. RESULTS: A total of 1,491 patients were included in the final analysis, while the other 17 patients lost contact. The follow-up duration was 12 to 74 months (27.8±14.6 months). Of 1,491 patients, 989 (66.3%) patients stopped OAC therapy 3 to 14 months after successful ablation during follow-up. Stroke or transient ischemic attack (TIA) occurred in 37 (2.5%) patients. Major bleeding occurred in 24 (1.6%) patients. Six (0.4%) patients died at follow-up. Patients who stopped OAC had lower CHA2DS2-VASc score (1.5±1.4 vs. 2.4±1.7, P<0.05) and lower incidence of major bleeding (11/989 vs. 13/502, P<0.05). Of 989 patients who stopped OAC, 318 stopped according to doctor's prescription, and 671 stopped on their own decision. In patients who underwent brain MRI, patients who stopped OAC had a lower incidence of silent cerebral infarction (SCI) (37/904 vs. 38/419, P<0.05). Among patients who did not stop warfarin therapy, there were 117 (117/397, 29.5%) patients had not to achieve target INR. CONCLUSIONS: The incidence of adverse events was relatively low in paroxysmal AF patients who stopped OAC. The patient partly determined when OAC was discontinued. Target INR was not achieved in many patients who had not to stop OAC.
BACKGROUND: To find out the real-world investigation on discontinuation of oral anticoagulation after paroxysmal atrial fibrillation (AF) catheter ablation China. METHODS: We enrolled in our study 1,508 consecutive paroxysmal AFpatients who underwent catheter ablation from five centers. Patients' clinical data and follow-up data were collected. Clinical data included on-admission characteristics such as gender, age, type and duration of AF, type of ablation, ablation sessions, history of diseases, CHA2DS2-VASc score, echocardiographic variables, medication, and blood test variables. Follow-up data included duration of follow-up, the status of oral anticoagulant (OAC) therapy, adverse events, and recurrence of AF. RESULTS: A total of 1,491 patients were included in the final analysis, while the other 17 patients lost contact. The follow-up duration was 12 to 74 months (27.8±14.6 months). Of 1,491 patients, 989 (66.3%) patients stopped OAC therapy 3 to 14 months after successful ablation during follow-up. Stroke or transient ischemic attack (TIA) occurred in 37 (2.5%) patients. Major bleeding occurred in 24 (1.6%) patients. Six (0.4%) patientsdied at follow-up. Patients who stopped OAC had lower CHA2DS2-VASc score (1.5±1.4 vs. 2.4±1.7, P<0.05) and lower incidence of major bleeding (11/989 vs. 13/502, P<0.05). Of 989 patients who stopped OAC, 318 stopped according to doctor's prescription, and 671 stopped on their own decision. In patients who underwent brain MRI, patients who stopped OAC had a lower incidence of silent cerebral infarction (SCI) (37/904 vs. 38/419, P<0.05). Among patients who did not stop warfarin therapy, there were 117 (117/397, 29.5%) patients had not to achieve target INR. CONCLUSIONS: The incidence of adverse events was relatively low in paroxysmal AFpatients who stopped OAC. The patient partly determined when OAC was discontinued. Target INR was not achieved in many patients who had not to stop OAC.