Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation

Qian XIN; Chuang ZHANG; Yu-Jia WANG; Jian LI; Tao CHEN; Shi-Xing LI; Wei WANG; Yu YANG; Wen-Juan SONG; Jin ZHOU; Xiang-Min SHI

doi:10.11909/j.issn.1671-5411.2022.08.004

Volume 19 Issue 8

Aug. 2022

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Article Navigation > Journal of Geriatric Cardiology > 2022 > 19(8): 565-574

Qian XIN, Chuang ZHANG, Yu-Jia WANG, Jian LI, Tao CHEN, Shi-Xing LI, Wei WANG, Yu YANG, Wen-Juan SONG, Jin ZHOU, Xiang-Min SHI. Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation. J Geriatr Cardiol 2022; 19(8): 565-574. doi: 10.11909/j.issn.1671-5411.2022.08.004

Citation:

Qian XIN, Chuang ZHANG, Yu-Jia WANG, Jian LI, Tao CHEN, Shi-Xing LI, Wei WANG, Yu YANG, Wen-Juan SONG, Jin ZHOU, Xiang-Min SHI. Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation. J Geriatr Cardiol 2022; 19(8): 565-574. doi: 10.11909/j.issn.1671-5411.2022.08.004

Citation:

Qian XIN, Chuang ZHANG, Yu-Jia WANG, Jian LI, Tao CHEN, Shi-Xing LI, Wei WANG, Yu YANG, Wen-Juan SONG, Jin ZHOU, Xiang-Min SHI. Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation. J Geriatr Cardiol 2022; 19(8): 565-574. doi: 10.11909/j.issn.1671-5411.2022.08.004

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Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation

doi: 10.11909/j.issn.1671-5411.2022.08.004

Qian XIN^{1, *},
Chuang ZHANG^{1, *},
Yu-Jia WANG^{1, *},
Jian LI¹,
Tao CHEN¹,
Shi-Xing LI¹,
Wei WANG¹,
Yu YANG¹,
Wen-Juan SONG¹,
Jin ZHOU²,
Xiang-Min SHI^{1
,
,}

1.
Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
2.
Department of Health Service, the Eighth Medical Centre, Chinese PLA General Hospital, Beijing, China

^*The authors contributed equally to this manuscript

More Information

Corresponding author: sxm301cardiac@163.com
Available Online: 2022-08-11
Publish Date: 2022-08-28

Abstract

Abstract

BACKGROUND Uninterrupted use of oral anticoagulants before atrial fibrillation (AF) ablation can reduce the incidence of perioperative thromboembolic events. However, the effect of new oral anticoagulants on activated clotting time (ACT) in response to heparin during AF ablation in Chinese populations remains unknown. The aim of the present retrospective study was to investigate the value of ACTs in response to intraoperative heparin administration in patients using dabigatran or rivaroxaban. METHODS From January 2018 to December 2021, a total of 173 patients undergoing AF ablation were included in the study, in which 101 patients were treated with dabigatran, 72 patients were treated with rivaroxaban. The intraoperative ACT values were examined in both groups. The incidence of periprocedural complications was evaluated. RESULTS Initial heparin dosage (88 ± 19 U/kg vs. 78 ± 27 U/kg, P < 0.05), total heparin dosage (137 ± 41 U/kg vs. 106 ± 52 U/kg, P < 0.05) during the ablation procedure were higher in the dabigatran group than those in the rivaroxaban group. Mean ACT (280 ± 36 s vs. 265 ± 30 s, P < 0.05), and the percentage of ACTs within the therapeutic range (250–350 s) (74% ± 26% vs. 60% ± 29%, P < 0.05) were significantly lower in the dabigatran group than those in the rivaroxaban group, particularly in male patients. Furthermore, the average time of achieving the target ACT (250–350 s) was also found longer in the dabigatran group (P < 0.05) as compared with the rivaroxaban group. No significant difference was found in the incidence of periprocedural complications between the two groups. CONCLUSIONS The anticoagulant effect of uninterrupted rivaroxaban therapy appears to be more stable and efficient than dabigatran administration during catheter ablation in patients with AF.

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References(21)

References

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