Effectiveness and safety of anticoagulation therapy with dabigatran etexilate in patients undergoing catheter ablation and cardioversion procedures for atrial fibrillation

Objective To evaluate effectiveness and safety of anticoagulation therapy with dabigatran etexilate in patients with atrial fibrillation(AF)undergoing catheter ablation and direct current cardioversion(CV). Methods A cohort of 96 patients who underwent catheter ablation and CV of AF was enrolled.The 96 patients were divided into two groups, 60 patients in dabigatran group and 36 in warfarin group.In dabigatran group, dabigatran(110 mg or 150 mg, bid)had been given for at least 2 month.In warfarin group, international normalized ratio(INR)was adjusted in the range between 2.0 and 3.0 during standard medication of warfarin.None of the patients changed anticoagulant during the anticoagulation therapy. Results ①There were no differences in baseline characteristics between two groups.②There were no differences between 2 groups on the death and thromboembolism events, including cerebral, systemic and pulmonary emboli(no patient in either dabigatran group or in warfarin group, P>0.05). There were no major bleeding events in either group.There were no significant differences in minor bleeding events between dabigatran group and warfarin group(2/60 vs.2/36, P>0.05). ③The length of hospital stay(including total, pre-ablation and post-ablation hospital stay)was significantly shorter in dabigatran group than in warfarin group. Conclusion Compared with oral warfarin, the effectiveness and safety of oral dabigatran have no inferior effect in the patients undergoing catheter ablation and CV of AF.Application of dabigatran is safe and effective in the AF patients with low or middle risk of thromboembolism, and could significantly decrease the length of hospital stay. Key words: Atrial fibrillation; Catheter ablation; Direct current cardioversion; Oral anticoagulant