Patients
This is a retrospective and multicenter study of the impact of 4
different minimally interrupted DOACs on the intraprocedural
anticoagulation and post-procedural hemoglobin drop following AF
ablation. The databases of AF
ablation were reviewed in Onomichi General Hospital, Hiroshima
General Hospital, and Hiroshima University Hospital. The data from
January 2016 to December 2019 were collected. The study protocol was
approved by the research committee of each institution. Consecutive
patients with AF were considered eligible for inclusion if they
underwent a radiofrequency-based pulmonary vein isolation for the first
time, and skipped a single dose of apixaban, dabigatran, edoxaban, or
rivaroxaban, prior to the ablation procedures. Patients were excluded if
they were prescribed with inappropriate DOAC dose regimens, underwent
their ablation procedures in the afternoon, or adjunctive ablation
procedures such as cavotricuspid isthmus ablation, linear lesions,
superior vena cava isolation, or ablation of non-pulmonary vein
triggers. Patients who were older than 65 years old were also excluded
since a choice of the DOAC was likely to be biased in an elderly
population due to safety concerns [6,7].
Blood samples were collected the day before and 24 hours after the
ablation in each patient. A complete blood cell count, coagulation
markers, and serum chemistry were measured. For risk stratification of
thromboembolisms and bleeding, the
CHA2DS2-VASc [8] and ORBID [9]
scores were calculated in all patients.