Abstract
Thank you for giving us the opportunity to respond to Dr Fauchier’s valid concerns. Dr Fauchier et al recommended holding dabigatran for ≥36 hours preablation and considering switching to weight-adapted LMWH (low-molecular-weight heparin). In addition, they recommended that the activated partial thromboplastin time (aPTT) ratio should be <1.2 before intervention because of concerns about reliability of monitoring the activated clotting time (ACT) at higher aPTT values. We agree that the data supporting use of ACT in patients on dabigatran are limited. Ideally, bleeding risk should have been assessed by the ecarin clotting time. However, this test is still not widely available and is limited to research centers. aPTT …
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