Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation?
<b>Aim:</b> International guidelines on the use of anti-thrombotic therapies in left-sided ablations other than atrial fibrillation (AF) are lacking. The data regarding antiplatelet or anticoagulation strategies after catheter ablation (CA) procedures mainly derive from AF, whereas for t...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/19/6183 |
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| author | Martina Nesti Fabiana Lucà David Duncker Francesco De Sensi Katarzyna Malaczynska-Rajpold Jonathan M. Behar Victor Waldmann Ahmed Ammar Gianluca Mirizzi Rodrigue Garcia Ahran Arnold Evgeny N. Mikhaylov Jedrzej Kosiuk Luigi Sciarra |
| author_facet | Martina Nesti Fabiana Lucà David Duncker Francesco De Sensi Katarzyna Malaczynska-Rajpold Jonathan M. Behar Victor Waldmann Ahmed Ammar Gianluca Mirizzi Rodrigue Garcia Ahran Arnold Evgeny N. Mikhaylov Jedrzej Kosiuk Luigi Sciarra |
| author_sort | Martina Nesti |
| collection | DOAJ |
| description | <b>Aim:</b> International guidelines on the use of anti-thrombotic therapies in left-sided ablations other than atrial fibrillation (AF) are lacking. The data regarding antiplatelet or anticoagulation strategies after catheter ablation (CA) procedures mainly derive from AF, whereas for the other arrhythmic substrates, the anti-thrombotic approach remains unclear. This survey aims to explore the current practices regarding antithrombotic management before, during, and after left-sided endocardial ablation, not including atrial fibrillation (AF), in patients without other indications for anti-thrombotic therapy. <b>Material and Methods:</b> Electrophysiologists were asked to answer a questionnaire containing questions on antiplatelet (APT) and anticoagulation therapy for the following left-sided procedures: accessory pathway (AP), atrial (AT), and ventricular tachycardia (VT) with and without structural heart disease (SHD). <b>Results:</b> We obtained 41 answers from 41 centers in 15 countries. For AP, before ablation, only four respondents (9.7%) used antiplatelets and two (4.9%) used anticoagulants. At discharge, APT therapy was prescribed by 22 respondents (53.7%), and oral anticoagulant therapy (OAC) only by one (2.4%). In patients with atrial tachycardia (AT), before ablation, APT prophylaxis was prescribed by only four respondents (9.7%) and OAC by eleven (26.8%). At discharge, APT was recommended by 12 respondents (29.3%) and OAC by 24 (58.5%). For VT without SHD, before CA, only six respondents (14.6%) suggested APT and three (7.3%) suggested OAC prophylaxis. At discharge, APT was recommended by fifteen respondents (36.6%) and OAC by five (12.2%). Regarding VT in SHD, before the procedure, eight respondents (19.5%) prescribed APT and five (12.2%) prescribed OAC prophylaxis. At discharge, the administration of anti-thrombotic therapy depended on the LV ejection fraction for eleven respondents (26.8%), on the procedure time for ten (24.4%), and on the radiofrequency time for four (9.8%), with a cut-off value from 1 to 30 min. <b>Conclusions:</b> Our survey indicates that the management of anti-thrombotic therapy surrounding left-sided endocardial ablation of patients without other indications for anti-thrombotic therapy is highly variable. Further studies are necessary to evaluate the safest approach to these procedures. |
| first_indexed | 2024-03-10T21:41:57Z |
| format | Article |
| id | doaj.art-a364d1dcfb124b34a47e969be9198782 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:41:57Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a364d1dcfb124b34a47e969be91987822023-11-19T14:35:14ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011219618310.3390/jcm12196183Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation?Martina Nesti0Fabiana Lucà1David Duncker2Francesco De Sensi3Katarzyna Malaczynska-Rajpold4Jonathan M. Behar5Victor Waldmann6Ahmed Ammar7Gianluca Mirizzi8Rodrigue Garcia9Ahran Arnold10Evgeny N. Mikhaylov11Jedrzej Kosiuk12Luigi Sciarra13Fondazione Toscana G. Monasterio, 56124 Pisa, ItalyCardiology Department, Grande Ospedale Metropolitano, 89129 Reggio Calabria, ItalyHannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, 30625 Hannover, GermanyCardiology Department, Misericordia Hospital, 58100 Grosseto, ItalyRoyal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, UKGeorges Pompidou European Hospital, 75015 Paris, FranceGeorges Pompidou European Hospital, 75015 Paris, FranceBarts NHS Trust, London E13 8SL, UKFondazione Toscana G. Monasterio, 56124 Pisa, ItalyCHU de Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, FranceNational Heart and Lung Institute, Imperial College London, London SW7 2BX, UKAlmazov National Medical Research Centre, 197341 Saint-Petersburg, RussiaRhythmology Department, Helios Clinic Köthen, 06366 Köthen, GermanyDepartment of Clinical Medicine, Public Health, Life and Environment Sciences, L’Aquila University, 67100 L’Aquila, Italy<b>Aim:</b> International guidelines on the use of anti-thrombotic therapies in left-sided ablations other than atrial fibrillation (AF) are lacking. The data regarding antiplatelet or anticoagulation strategies after catheter ablation (CA) procedures mainly derive from AF, whereas for the other arrhythmic substrates, the anti-thrombotic approach remains unclear. This survey aims to explore the current practices regarding antithrombotic management before, during, and after left-sided endocardial ablation, not including atrial fibrillation (AF), in patients without other indications for anti-thrombotic therapy. <b>Material and Methods:</b> Electrophysiologists were asked to answer a questionnaire containing questions on antiplatelet (APT) and anticoagulation therapy for the following left-sided procedures: accessory pathway (AP), atrial (AT), and ventricular tachycardia (VT) with and without structural heart disease (SHD). <b>Results:</b> We obtained 41 answers from 41 centers in 15 countries. For AP, before ablation, only four respondents (9.7%) used antiplatelets and two (4.9%) used anticoagulants. At discharge, APT therapy was prescribed by 22 respondents (53.7%), and oral anticoagulant therapy (OAC) only by one (2.4%). In patients with atrial tachycardia (AT), before ablation, APT prophylaxis was prescribed by only four respondents (9.7%) and OAC by eleven (26.8%). At discharge, APT was recommended by 12 respondents (29.3%) and OAC by 24 (58.5%). For VT without SHD, before CA, only six respondents (14.6%) suggested APT and three (7.3%) suggested OAC prophylaxis. At discharge, APT was recommended by fifteen respondents (36.6%) and OAC by five (12.2%). Regarding VT in SHD, before the procedure, eight respondents (19.5%) prescribed APT and five (12.2%) prescribed OAC prophylaxis. At discharge, the administration of anti-thrombotic therapy depended on the LV ejection fraction for eleven respondents (26.8%), on the procedure time for ten (24.4%), and on the radiofrequency time for four (9.8%), with a cut-off value from 1 to 30 min. <b>Conclusions:</b> Our survey indicates that the management of anti-thrombotic therapy surrounding left-sided endocardial ablation of patients without other indications for anti-thrombotic therapy is highly variable. Further studies are necessary to evaluate the safest approach to these procedures.https://www.mdpi.com/2077-0383/12/19/6183left-sided ablationsanticoagulation therapyventricular tachycardiaatrial tachycardia |
| spellingShingle | Martina Nesti Fabiana Lucà David Duncker Francesco De Sensi Katarzyna Malaczynska-Rajpold Jonathan M. Behar Victor Waldmann Ahmed Ammar Gianluca Mirizzi Rodrigue Garcia Ahran Arnold Evgeny N. Mikhaylov Jedrzej Kosiuk Luigi Sciarra Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation? Journal of Clinical Medicine left-sided ablations anticoagulation therapy ventricular tachycardia atrial tachycardia |
| title | Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation? |
| title_full | Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation? |
| title_fullStr | Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation? |
| title_full_unstemmed | Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation? |
| title_short | Antiplatelet and Anti-Coagulation Therapy for Left-Sided Catheter Ablations: What Is beyond Atrial Fibrillation? |
| title_sort | antiplatelet and anti coagulation therapy for left sided catheter ablations what is beyond atrial fibrillation |
| topic | left-sided ablations anticoagulation therapy ventricular tachycardia atrial tachycardia |
| url | https://www.mdpi.com/2077-0383/12/19/6183 |
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