Display options
Cite
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.
Copy Download .nbib Format: NLM
Share it on

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, Munich, Germany. Electronic address: [email protected].
  2. Department of Electrophysiology, German Heart Center Munich, Technical University Munich, 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 (VKAs), direct oral anticoagulants (DOACs) are increasingly used in this patient population.

OBJECTIVE: The purpose of this study was to assess the safety of catheter ablation in ACHD patients on uninterrupted oral anticoagulation with VKA or DOAC, examining thromboembolic, bleeding, and 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 in 97, right AT in 181, left AT in 65, or a combination of AF and AT in 25.

RESULTS: No thromboembolic complications occurred. Major complications occurred in 4 patients (1.1%; 1 VKA, 3 DOAC), including retroperitoneal hematoma in 2 and arteriovenous (AV) fistula requiring surgical treatment in 2. Minor bleeding or vascular access complications occurred in 46 cases (12.5%), including hematomas >5 cm in 26, AV fistulas (not requiring surgical intervention) in 13, and pseudoaneurysms in 7 (thrombin injection in 3/7). Overall, no significant difference was found between DOAC (14.9%) and VKA groups (12.0%; P = .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 differences regarding minor bleeding or vascular access complications between patients on DOAC or VKA were found.

Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Keywords: Adult congenital heart disease; Atrial fibrillation; Catheter ablation; Direct oral anticoagulant; Oral anticoagulation

Publication Types