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Foerschner L, Kriesmair J, Telishevska M, et al. Catheter Ablation in Adult Congenital Heart Disease on uninterrupted oral anticoagulation: Is it safe? - Data from a large single center study. Heart Rhythm. 2021;doi: 10.1016/j.hrthm.2021.12.018.
Foerschner, L., Kriesmair, J., Telishevska, M., Kottmaier, M., Bourier, F., Reents, T., Lengauer, S., Lennerz, C., Krafft, H., Maurer, S., Popa, M., Kolb, C., Deisenhofer, I., & Hessling, G. (2021). Catheter Ablation in Adult Congenital Heart Disease on uninterrupted oral anticoagulation: Is it safe? - Data from a large single center study. Heart rhythm, . https://doi.org/10.1016/j.hrthm.2021.12.018
Foerschner, Leonie, et al. "Catheter Ablation in Adult Congenital Heart Disease on uninterrupted oral anticoagulation: Is it safe? - Data from a large single center study." Heart rhythm vol. (2021). doi: https://doi.org/10.1016/j.hrthm.2021.12.018
Foerschner L, Kriesmair J, Telishevska M, Kottmaier M, Bourier F, Reents T, Lengauer S, Lennerz C, Krafft H, Maurer S, Popa M, Kolb C, Deisenhofer I, Hessling G. Catheter Ablation in Adult Congenital Heart Disease on uninterrupted oral anticoagulation: Is it safe? - Data from a large single center study. Heart Rhythm. 2021 Dec 24; doi: 10.1016/j.hrthm.2021.12.018. Epub 2021 Dec 24. PMID: 34958942.
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Heart Rhythm. 2021 Dec 24; doi: 10.1016/j.hrthm.2021.12.018. Epub 2021 Dec 24.

Catheter Ablation in Adult Congenital Heart Disease on uninterrupted oral anticoagulation: Is it safe? - Data from a large single center study.

Heart rhythm

Leonie Foerschner, Julia Kriesmair, Marta Telishevska, Marc Kottmaier, Felix Bourier, Tilko Reents, Sarah Lengauer, Carsten Lennerz, Hannah Krafft, Susanne Maurer, Miruna Popa, Christof Kolb, Isabel Deisenhofer, Gabriele Hessling

Affiliations

  1. Department of Electrophysiology, German Heart Center Munich, Technical University Munich, Lazarettstr. 36, 80636 Munich, Germany.. Electronic address: [email protected].
  2. Department of Electrophysiology, German Heart Center Munich, Technical University Munich, Lazarettstr. 36, 80636 Munich, Germany.

PMID: 34958942 DOI: 10.1016/j.hrthm.2021.12.018

Abstract

BACKGROUND: Catheter ablation in adult congenital heart disease (ACHD) patients is a critical treatment strategy for complex arrhythmias including atrial fibrillation (AF) and atrial tachycardia (AT). In addition to vitamin K antagonists (VKA), direct oral anticoagulants (DOACs) are increasingly used in this patient population.

OBJECTIVE: The study assessed the safety of catheter ablation in ACHD patients on uninterrupted oral anticoagulation with VKA or DOAC examining thromboembolic, bleeding or vascular access complications.

METHODS: Retrospective analysis of 234 ACHD patients with simple (n=83), moderate (n=66) or complex (n=85) CHD (mean age 46 years) undergoing 368 ablation procedures on uninterrupted oral anticoagulation with VKA (45.4%) or DOAC (54.6 %) was undertaken. Arrhythmias were AF (n=97, right AT (n=181), left AT (n=65) or a combination of AF and AT (n=25).

RESULTS: No thromboembolic complications occurred. There were major complications in 4 patients (1.1%; VKA n=1, DOAC n=3) including retroperitoneal hematoma (n=2) and AV fistula requiring surgical treatment (n=2). Minor bleeding or vascular access complications occurred in 46 cases (12.5%) including hematomas >5cm (n=26), AV fistulas (not requiring surgical intervention) (n=13) or pseudoaneurysms (n=7; thrombin injection in 3/7). Overall, no significant difference was found between the DOAC (14.9%) and the VKA group (12. 0%; p=0.411).

CONCLUSION: Catheter ablation in ACHD patients on uninterrupted oral anticoagulation with VKA or DOAC is feasible and safe. No thromboembolic events occurred, and major bleeding or vascular access complications were rare. No significant difference regarding minor bleeding or vascular access complications between patients on DOAC or VKA were found.

Copyright © 2021. Published by Elsevier Inc.

Keywords: Adults with Congenital Heart Disease; Atrial Fibrillation; Catheter Ablation; Direct Oral Anticoagulants; Oral Anticoagulation

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