ANTICOAGULATION THERAPY DURING RADIOFREQUENCY ABLATION

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.