Thirty-day clinical outcomes after an atrial flutter ablation in patients on dabigatran: The Flutter French prospective study

Purpose To evaluate the clinical management and 30-day outcomes of patients taking dabigatran and undergoing atrial flutter ablation in everyday clinical practice. Methods Study Flutter is a multicentre, observational, prospective study of patients undergoing an atrial flutter ablation. Eligible patients had been taking dabigatran (150 or 110 mg twice daily) for ≥ 3 weeks before the procedure and were followed for 30 days afterwards. Results A total of 90 patients (71 ± 12 years, 81% male, mean CHA2DS2-VASc score 2.2 ± 1.3) were enrolled at 10 academic/non-academic centers in France. The most prevalent concomitant disorders were hypertension (31% of patients), diabetes (15%) and vascular disease (11%). Only 6 patients (6.7%) had a history of stroke. Mean creatinine value was 88 ± 22 mmol/L, mean creatinine clearance (Cockroft − Gault) was 85 ± 35 mL/min, and median weight was 83 ± 19 kg. Sixty-five patients (73%) were receiving dabigatran 300 mg/day and 25 (27%) 220 mg/day. The patients were receiving dabigatran at 220 mg/day because of an age ≥ 80 year old for 24 patients (26.7%), an age between 75 and 80 years old and an aspirin treatment (1 patient). Dabigatran was not or shortly discontinued before flutter catheter ablation, with a median duration of interruption of 5 ± 8 hours. Preprocedural bridging with therapeutic LMWH was performed in only one patient with enoxaparin twice daily. Among the patients, 19 (21%) had a TEE before the procedure. No thromboembolic event, major bleeding complications or death were recorded within 30 days of the procedure. Conclusion These preliminary observational data of patients on dabigatran undergoing atrial flutter ablation procedures in everyday practice show a good safety at 30 days.