Pulmonary vein isolation is an effective strategy in patients with atrial fibrillation (AF). The peri-procedural use of anticoagulation is routinely employed to reduce thromboembolic risk.The aim of this study was to compare the use of Dabigatran to the other 2 strategies involving the use of Warfarin. Single centre observational study comparing 3 anticoagulation strategies: Group 1 consisted of patients maintained on Warfarin (5.15 ± 2.52 mg) with a therapeutic INR of 2-3. Group 2 comprised patients initially treated with Warfarin (6.98 ± 3.17 mg), which was discontinued 1 week prior to LA ablation, during which time patients were bridged with a therapeutic dose of Dalteparin. Group 3 included patients anticoagulated with Dabigatran (40 patients received 150 mg BID, 3 patients received 110 mg BID), which was discontinued 24-30 h prior to the procedure.A total of 207 patients were included in the study. There were no significant differences in age, sex, LA volume, CHADS2 score or proportion of patients with persistent AF. There were no significant differences in the number of patients with intra-cardiac thrombus found at TOE (Group 1: 2.3% vs. Group 2: 1.5% vs. Group 3: 0%; P = 0.37). Furthermore, there were no differences in the rate of groin hematoma (2.2% vs. 1.5% vs. 2.3%; P = 0.8) or the development of pericardial effusion (5.4% vs. 8.8% vs. 2.3%; P = 0.54). No thromboembolic events were seen.Peri-procedural use of Dabigatran during AF ablation procedures is safe, with no significant difference when compared to conventional anticoagulation with either Warfarin bridged with Dalteparin or uninterrupted Warfarin.

Peri

10.1111/1755-5922.12082

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Citations (9)

174 Reverse atrial electrical remodeling induced by CPAP in patients with severe sleep apnea

Canadian Journal of Cardiology (2011)

H Pang D. P. Redfearn C.S. Simpson K. Michael Edísio Pereira

Apnea–hypopnea index

10.1016/j.cjca.2011.07.122

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Citations (2)

Clinical Arrhythmology

Antoni Bayés de Luna Adrián Baranchuk

10.1002/9781119212782

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Citations (32)

Guidelines for the Prevention of Sudden Cardiac Death: Filling the Gap

Springer eBooks (2006)

Adrián Baranchuk Carlos A. Morillo

10.1007/88-470-0341-5_26

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Citations (4)

Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis

BMC Cardiovascular Disorders (2017)

Antoni Bayés de Luna Manuel Martínez‐Sellés Antoni Bayés‐Genís Roberto Elosúa Adrián Baranchuk

Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with stroke, cognitive impairment, and cardiovascular death. Some predisposing factors − as aging, diabetes, hypertension − induce and maintain electrophysiological and ultrastructural remodeling that usually includes fibrosis. Interatrial conduction disturbances play a crucial role in the initiation of atrial fibrosis and in its associated complications. The diagnosis of interatrial blocks (IABs) is easy to perform using the surface ECG. IAB is classified as partial when the P wave duration is ≥120 ms, and advanced if the P wave also presents a biphasic pattern in II, III and aVF. IAB is very frequent in the elderly and, particularly in the case of the advanced type, is associated with AF, AF recurrences, stroke, and dementia. The anticoagulation in elderly patients at high risk of AF without documented arrhythmias is an open issue but recent data suggest that it might have a role, particularly in elderly patients with structural heart disease, high CHA2DS2VASc (Congestive heart failure/left ventricular dysfunction, Hypertension, Age ≥ 75 [doubled], Diabetes, Stroke [doubled] – Vascular disease, Age 65–74, and Sex category [female]), and advanced IAB. In this debate, we discuss the association of surface ECG IAB, a marker of atrial fibrosis, with AF and stroke. We also present the rationale that justifies further studies regarding anticoagulation in some of these patients.

Angiology

Stroke

10.1186/s12872-017-0650-y

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Citations (34)

Safety and Efficacy of Novel Multipolar Steerable Mapping Catheter in Atrial Arrhythmia: A Single Centre Experience

Authorea (Authorea) (2020)

Thalia Hua Damian Redfearn Andrés Enríquez Benedict M. Glover Danielle Hart

Background: There is limited data on the safety and efficacy of a novel high-definition mapping catheter with 16 equidistant electrodes (Advisor HD Grid). We describe procedural details for the treatment of complex atrial arrhythmias and associated outcomes using this novel catheter design. Methods and Results: The HD Grid was employed for patients with clinically relevant arrhythmia using the EnSite Precision™ electroanatomic mapping system. AVRT and typical flutter cases were excluded. Major procedural complications were defined as bleeding, stroke or TIA, sepsis, and death from any cause, whereas minor complications were defined as no changes to the length of hospital stay or to the expected management of the patient. Recurrence was defined as sustained tachycardia after 3 months post-procedure. Consecutive patients attending for the treatment of paroxysmal atrial fibrillation (66), persistent atrial fibrillation (38), atrial tachycardia (29), and atypical flutter (18) were included, resulting in a final inclusion of 142 patients and 151 procedures. Eighty-four patients (55.3%) received general anesthetic and intracardiac echocardiography was used in 23 (15.1%). Long term follow-up was available in 150/151 procedures, mean 185.2±134.3 days; 32 patients (21.3%) documented recurrence. Three (2.0%) patients experienced complications within 30-days of the procedure including acute tamponade (1), TIA (1) and stroke (1) and 1 (0.7%) died from complications of septic arthritis 183 days post-procedure. Conclusion: The novel HD Grid differs significantly in design and handling compared to the traditional multielectrode catheters. Our data report procedural outcomes in line with contemporary clinical expectations with low complication and recurrence rates.

Stroke

Atrial tachycardia

10.22541/au.159050308.83665725

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Citations (0)

Syncope in a Patient With Wolff-Parkinson-White Pattern

JAMA Internal Medicine (2019)

Bryce Alexander Sohaib Haseeb Adrián Baranchuk

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal

10.1001/jamainternmed.2018.7646

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Citations (1)

554 Predictors of inappropriate therapy in patients with implantable cardioverter-defibrillators and chagas' cardiomyopathy

Canadian Journal of Cardiology (2011)

Rita Miranda Francisco Femenía Judith Lopez J. Serra Christopher S. Muratore

Medical Therapy

10.1016/j.cjca.2011.07.458

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Citations (0)

[Incessant focal atrial tachycardia arising from the right appendage: risk of tachycardia mediated cardiomyopathy. Role of the radiofrequency ablation].

Archivos Argentinos de Pediatria (2011)

Francisco Femenía Mauricio Arce Martín Arrieta Adrián Baranchuk

Focal atrial tachycardias originate from different anatomic regions of the right atrium including the crista terminalis, the coronary sinus ostium, the tricuspid annulus, the interatrial septum and the right atrial appendage. The latter are characterized by being incessant and presenting poor response to antiarrhythmic treatment. They frequently evolve into tachycardiomyopathy and radiofrequency ablation is the treatment of choice. We present the case of a 36 month old girl with tachycardiomyopathy as a result of an incessant atrial tachycardia originated in the right atrial appendage. Patient underwent radiofrequency ablation.

Crista terminalis

Fossa ovalis

Interatrial septum

Ostium

10.1590/s0325-00752011000200014

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Citations (2)