Efficacy and safety of perioperative anticoagulation therapy with different medication methods of rivaroxaban for atrial fibrillation ablation

Objective This study was to explore the efficacy and safety of rivaroxaban used in different medication regimen during perioperative anticoagulation of atrial fibrillation (AF) catheter ablation. Methods Two hundred and fifty seven consecutive patients with paroxysmal AF undergoing catheter ablation were enrolled in this study from January 2015 to December 2016 and were divided into A, B, C three groups. Group A (91 cases) : rivaroxaban 10 mg, bid; Group B (66 cases) : rivaroxaban 20 mg, qd; C group (100 cases) : rivaroxaban 20 mg, qn. Observation the bleeding and thromboembolism of perioperative and postoperative two months. Results All of the ablation data including procedure time, X-ray exposure and perioperative complications showed no significant difference among three groups. Neither thromboembolic events (death, cerebral embolism, pulmonary artery embolism and systemic embolism) nor severe hemorrhage events occurred in three groups. Mild bleeding events occurred in 6 of 91 patients (6.5%) in Group A, including puncture hematoma in 3 patients, gingival hemorrhage in 1 patient; in 9 of 66 patients (13.6%) in Group B, including puncture hematoma in 6 patients; and in 8 of 100 patients (8%) in Group C, including puncture hematoma in 4 patients. There was no significant difference in mild bleeding events among three groups. Conclusion It is all effective and safe using three different medication regimens of rivaroxaban (10 mg, bid; 20 mg, qd; 20 mg, qn) for perioperative anticoagulation therapy for AF ablation. The regimen of rivaroxaban of 20 mg, qn might be better for patient adherence. Key words: Radiofrequency catheter ablation; Rivaroxaban