• Am. J. Cardiol. · Jul 2017

    Multicenter Study Comparative Study

    Comparison of the Incidences of Complications After Second-Generation Cryoballoon Ablation of Atrial Fibrillation Using Vitamin K Antagonists Versus Novel Oral Anticoagulants.

    • Giacomo Mugnai, Carlo de Asmundis, Saverio Iacopino, Erwin Stroker, Massimo Longobardi, Valentina De Regibus, Hugo Enrique Coutino-Moreno, Ken Takarada, Rajin Choudhury, Juan Pablo Abugattas de Torres, Cesare Storti, Pedro Brugada, and Gian-Battista Chierchia.
    • Heart Rhythm Management Center, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium; Electrophysiology and Cardiac Pacing Unit, Cardiology Department, Istituto di Cura Città di Pavia, Pavia, Italy. Electronic address: mugnai.giacomo@gmail.com.
    • Am. J. Cardiol. 2017 Jul 15; 120 (2): 223-229.

    AbstractData evaluating the impact of the periprocedural administration of novel oral anticoagulants (NOACs) on complications in the setting of pulmonary vein (PV) isolation using cryoballoon (CB) is limited. In the present study, our aim was to analyze procedural characteristics and incidence of complications in those patients who underwent CB ablation for atrial fibrillation and the impact of NOACs on adverse events compared with vitamin K antagonists (VKAs). Consecutive patients with drug resistant atrial fibrillation who underwent PV isolation by CB as index procedure were retrospectively included in our analysis. In group I, 290 of 454 patients (63.9%) received VKAs (warfarin: n = 222 and acenocoumarol: n = 68), and in group II, 164 of 454 patients (36.1%) were treated with NOACs (rivaroxaban: n = 71; dabigatran: n = 60; and apixaban: n = 33). Age was significantly higher in the group II (62.8 ± 9.7 vs 58.6 ± 11.3; p <0.001). During the study period, 454 consecutive patients (male 71%, age 60.1 ± 10.9 years) were enrolled. Major complications occurred in 9 patients (2.0%): peripheral vascular complications were observed in 6 patients (1.3% per procedure), persistent phrenic nerve palsy occurred in 2 (0.4%), and transient ischemic attacks in 1 (0.2%). In both groups, the incidence of major complications was similar (group I [VKAs]: 7 patients [2.4%] vs group II [NOACs]: 2 patients [1.2%]; p = 0.5). In conclusion, CB ablation is a safe procedure for PV isolation and is associated with low complication rates. The incidence of adverse events in PV isolation using the second-generation CB with the periprocedural administration of NOACs is not significantly different than VKA treatment.Copyright © 2017 Elsevier Inc. All rights reserved.

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