Table 1.
Studies of dabigatran for anticoagulation before, during, and after pulmonary vein isolation
| Mendoza et al. [16] |
Rowley et al. [17] |
Ellis et al. [18] | Lakkireddy et al. [19] |
Kaseno et al. [20] |
Snipelisky et al. [21] |
Kim, et al. [22] |
Maddox et al. [23] |
Haines et al. [24] |
Bassiouny et al. [25] |
|
|---|---|---|---|---|---|---|---|---|---|---|
| Publication/meeting | HRS | HRS | HRS | JACC | Circ J | J Interv Card Electrophysiol | Heart Rhythm | J Cardiovasc Electrophysiol | J Interv Card Electrophysiol | Circ Arrhythm Electrophysiol |
| Year | 2012 | 2012 | 2012 | 2012 | 2012 | 2012 | 2013 | 2013 | 2013 | 2013 |
| Number of centers | 1 | 1 | 1 | 8 | 1 | 1 | 1 | 1 | 5 | 1 |
| Total patients | 118 | 282 | 171 | 290 | 211 | 156 | 763 | 463 | 404 | 999 |
| Pre-procedure | ||||||||||
| INR goal (warfarin group) | 2–3 | 2.0 | 2–3.5 | 2–3 | 2–3a | 2–3 | 2–3 | – | – | |
| Dabigatran dose | 150 mg bid | – | – | 150 mg bid | 110 mg bid | 150 mg bid | 150 mg bid | 150 mg bid | – | 150 mg bid |
| Time of last dabigatran dose pre-procedure | Held in AM | Held in AM | 12–24 h prior | Held in AM | Held in AM | Held in AM | Held night before | Taken in AM | 2.5–48 h prior | 1–2 doses held |
| Periprocedure | ||||||||||
| Irrigated catheter | – | – | – | Yes (ThermoCool) | Yes (ThermoCool) | – | Yes (ThermoCool) | Yes | Mixed | Yes |
| ACT goal (for UFH) | 300–350 s | – | 300–350 s | 300–400 s | 300–350 sb | ≥350 s | 300–350 s | 350–400 s | 300–350 s | 350–450 s |
| Bridging with LMWH | No | Yes | Yes | No | No | No | No | No | Yes | No |
| Post-procedure | ||||||||||
| Dabigatran restart timing | After sheath removal | Next day | 4–24 h post-procedure | 0–3 h post-procedure | Morning after procedure | Evening after procedure | 4 h post-procedure | Evening after procedure | 4–12 h post-procedure | Immediately post-procedure |
| Follow-up duration | 1 month | – | 1 month | 30 days | 2 months | 1 week | 3 months | – | – | 3 months |
Dashes indicate unreported data
HRS Heart Rhythm Society; JACC Journal of the American College of Cardiology; Circ J Circulation Journal: Official Journal of the Japanese Circulation Society; Circ Arrhythm Electrophysiol: Circulation: Arrhythmia and Electrophysiology; INR international normalized ratio; ACT activated clotting time natriuretic peptide; UFH unfractionated heparin; LMWH low-molecular weight heparin
a
Patients on warfarin held the dose the evening prior to the procedure
b
Patients in each group received 10,000 units of UFH for 24 h after the procedure