LEFT ATRIAL APPENDAGE CLOSURE UNDER LOCAL ANESTHESIA GUIDED BY INTRA-CARDIAC ECHOCARDIOGRAPHY FROM THE LEFT ATRIUM

Abstract

bridged warfarin in patients undergoing radiofrequency ablation for AF, at our centre. METHODS: Two-hundred and forty-nine consecutive patients undergoing radiofrequency ablation for AF or left atrial flutter, between January 2011 to July 2013, were included. Periprocedural anticoagulation with dabigatran (n1⁄4112) was compared with bridged warfarin (n1⁄4137). Primary outcome was a composite of complications including major and minor bleeding, stroke and systemic embolism. RESULTS: Mean age was 58.6 10.6; warfarin group compared to 56.9 10.7 in the dabigatran group. Mean CHADS2 score was 0.8 0.9 in the warfarin group vs. 0.7 0.9 in the dabigatran group. Mean CHA2DS2VASc score was 1.4 1.2 in the warfarin group vs 1.3 1.2 in the dabigatran group. Major bleeding occurred in 5 (3.6%) patients in the warfarin group compared to none in the dabigatran group (p1⁄4 0.06). Groin hematoma was reported in 5 (3.6%) patients in warfarin group and 2 (1.8%) in the dabigatran group (p1⁄40.46). No patient had stroke and 1 (0.7%) patient in the warfarin group developed TIA (p1⁄40.36). Pericardial effusion not requiring drainage was observed in 3 (2.7%) patients in the dabigatran group vs. 1 (0.7%) in the warfarin group (p1⁄40.33). Combined end point occurred in 12 patients in the warfarin group vs, 6 in the dabigatran group (p1⁄40.20). CONCLUSION: Periprocedural complications with oral anticoagulants post AF ablation are rare. Dabigatran appears to be a safe and effective alternative to bridged warfarin in patients at low risk of stroke and bleeding undergoing radiofrequency ablation for AF. 200 LEFT ATRIAL APPENDAGE CLOSURE UNDER LOCAL ANESTHESIA GUIDED BY INTRA-CARDIAC ECHOCARDIOGRAPHY FROM THE LEFT ATRIUM