Low-Dose Dabigatran May Be Safely Used as an Alternative to Warfarin for Peri-Procedural Anticoagulation During Atrial Fibrillation Ablation

Abstract

Peri-procedural anticoagulation for atrial fibrillation (AF) ablation must be optimized to reduce the occurrence of bleeding and thromboembolic complications. In this study, the safety of two anticoagulants were compared between the commonly used warfarin and a potential alternative, orally administered low-dose (110 mg bid) dabigatran. A total of 117 Han Chinese patients undergoing AF ablation were included in the study. In all, 67 patients were administered dabigatran (110 mg) twice daily, while the other 50 received a therapeutically effective dose of warfarin. Thromboembolic and bleeding complications were compared between the two groups. No significant baseline differences were found between the groups. Only one thromboembolic complication (2.0%) occurred in the warfarin group, while no complications occurred in the dabigatran group (p = 0.43). Compared to the warfarin group, the dabigatran group showed a similar rate of major bleeding events (2.0% vs. 0; p = 0.43), but a significantly lower rate of minor bleeding events (9.0% vs. 22%; p = 0.048), total bleeding events (9% vs. 24%; p = 0.03), and bleeding and thromboembolic complications taken together (9% vs. 26%; p = 0.01). In Conclusion, the incidence of minor bleeding events after AF ablation was lower in those administered low-dose dabigatran (110 mg bid) than in those administered warfarin, while the risks of thromboembolic and major bleeding complications were similar between the two groups. This result indicates that low-dose dabigatran would be safer than warfarin in Chinese patients undergoing AF ablation.