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ANTICOAGULATION THERAPY DURING RADIOFREQUENCY ABLATION

https://doi.org/10.47093/22187332.2019.1.63-68

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Abstract

Purpose. The study assess the effectiveness and safety of pulmonary veins atriums isolation (PVI) and radiofrequency ablation of the cavo - tricuspid isthmus with different modes of anticoagulation in patients with atrial fibrillation (AFb) and atrial flutter (AFl). Materials and methods. The study included 83 patients - 52 with AFb, 18 - with AFl and 13 - with both types of arrhythmia. Of all the included patients 12 used warfarin for antioagulation (15%), 17 - dabigataran (21%), 39 - rivaroxaban (46%) and 15 - apixaban (18%). For patients using warfarin a “bridge therapy” tactic was used. For patients using POAC the drug was cancelled at 2 half - life periods before the procedure. Intraoperational thromboembollic and haemorrhagic complications were calculated, arrhythmia relapses and delayed complications were controlled in 3 and 6 months after the procedure. Results. 18 arrhytmia relapses were reported during the study, among them 79% happened after PVI, 89% - after cavotricuspid isthmus, 62% - after treatment of both types of arrhythmia. 4 major haemorrhagic complications were reported during the study (intraoperational haemopericardium), 3 major thromboembolic complications (a stroke through 6 months after the procedure). The frequency of minor hemorrhagic events amounted to 8 cases. Both modes of anticoagulation are effective and safe for prevention of thromboembolic events in atrial fibrillation and flutter correction surgery, however, a large, although statistically insignificant number of minor haemorrhagic events occurred in the early post - procedure period with dabigataran. The results of the study show the effectiveness of arrhythmia surgery to be 79% in patients with AFb and 89% in patients with AFl.

About the Authors

S. A. Shidlovskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation


M. Yu. Gilyarov
I.M. Sechenov First Moscow State Medical University (Sechenov University); N.I. Pirogov City Clinical Hospital №1
Russian Federation


A. A. Bogdanova
I.M. Sechenov First Moscow State Medical University (Sechenov University); N.I. Pirogov City Clinical Hospital №1
Russian Federation


G. A. Gromyko
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation


A. Yu. Kuchina
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation


N. V. Safonov
People’s Friendship University of Russia
Russian Federation


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ISSN 2218-7332 (Print)
ISSN 2658-3348 (Online)