Abstract 14307: Periprocedural Stokes and Anticoagulation Management During AF Ablation: Results From the “Compare" Randomized Multicenter Trial

Introduction: Iatrogenic periprocedural thromboembolic (TE) events are insidious complications of catheter ablation for atrial fibrillation (AF). We sought to determine whether the type of AF and the anticoagulation management with warfarin play a role in the reduction of periprocedural TE in a randomized multicenter study. Methods: This was an open-label, randomized, parallel-group, multicenter study assessing the role of continuous warfarin in preventing periprocedural TE events after radio frequency catheter ablation. Patients with CHADS2 score Results: The study enrolled 1584 pts (429 PAF, 1155 non-paroxysmal AF (non-PAF); 790 pts were assigned to discontinue warfarin (group 1) and 794 pts to continuous warfarin (group 2). There were 39 TE [3.7% (29) strokes and 1.3% (10) TIA] events in group 1; 2 (0.8%) in PAF (paroxysmal), 5 (2.9%) in persistent AF, and 32 (8.2%) in LSP AF with a total of 37 TE events in non-PAF. Two (0.25%) strokes in LSP pts were observed in group 2 (p Conclusions: This multicenter randomized study shows that in higher risk pts therapeutic INR protect against peri-procedural thromboembolic events. The risk of these complications during AF ablation is predominantly confined to pts with non paroxysmal AF. Therefore, future studies assessing the protecting value of newer anticoagulants should be performed in comparison with on warfarin treatment and enrolling pts with LSPAF since in paroxysmal pts these events are relatively rare.