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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >A randomized controlled trial of dabigatran versus warfarin for periablation anticoagulation in patients undergoing ablation of atrial fibrillation
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A randomized controlled trial of dabigatran versus warfarin for periablation anticoagulation in patients undergoing ablation of atrial fibrillation

机译：达比加群与华法林对房颤消融患者围手术期抗凝的随机对照试验

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Background We aimed to evaluate the feasibility of an oral direct thrombin inhibitor, dabigatran, as a periprocedural anticoagulant for use with ablation of atrial fibrillation (AF). Methods Consecutive patients scheduled to undergo an AF ablation were randomly assigned to receive dabigatran (n = 45) or warfarin (n = 45) to compare their clinical feasibility. Both of those oral anticoagulants were discontinued the day before the ablation and were resumed after confirming hemostasis of the venipuncture site. A bridging therapy with heparin was not used in either of the patient groups. Results Dabigatran was switched to warfarin before the ablation because of dyspepsia in three patients. An occurrence of rebleeding from the venipuncture site was less common in dabigatran-allocated patients than in warfarin-allocated patients (20% vs 44%; P = 0.013). The reduction in the D-dimer level after the initiation of oral anticoagulants was greater in the dabigatran-allocated patients than in the warfarin-allocated patients. The time from the initiation of the anticoagulants to the ablation was significantly shorter in the dabigatran-allocated patients than in the warfarin-allocated patients (43 ?? 7 vs 63 ?? 13 days; P < 0.0001). There was only one fatal periprocedural complication in a patient receiving warfarin, who had a mesenteric arterial thrombosis after the ablation. Conclusions An anticoagulation strategy with dabigatran may surpass that with warfarin in reducing both the periprocedural risk of minor bleeding and a hypercoagulable state, and the time to ablation in patients undergoing ablation of AF. ?2012, The Authors. Journal compilation ?2012 Wiley Periodicals, Inc.
机译：背景技术我们旨在评估口服直接凝血酶抑制剂达比加群作为房颤围手术期抗凝剂用于房颤消融的可行性。方法将计划进行房颤消融的连续患者随机分配接受达比加群（n = 45）或华法林（n = 45）以比较其临床可行性。消融前一天停用这两种口服抗凝剂，并在确认静脉穿刺部位止血后恢复使用。两组患者均未使用肝素桥接治疗。结果3例患者由于消化不良而在消融前将达比加群改为华法林。分配达比加群的患者从静脉穿刺部位再出血的发生率比华法林分配的患者少（20％vs 44％; P = 0.013）。达巴加群分配患者中口服抗凝剂启动后D-二聚体水平的降低幅度大于华法林分配患者中。分配达比加群的患者从开始使用抗凝剂到消融的时间明显短于华法林分配的患者（43 d 7 vs 63 d 13 13; P <0.0001）。接受华法令的患者只有一个致命的围手术期并发症，该患者在消融后发生了肠系膜动脉血栓形成。结论达比加群的抗凝策略在降低房颤消融的围手术期轻微出血和高凝状态的风险以及消融时间方面可能优于华法林。 2012年，作者。期刊汇编？2012 Wiley Periodicals，Inc.

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