Atrial fibrillation ablation

Transcatheter ablation can be used in case of atrial fibrillation (AF) not controlled by medical therapy due to lack of efficacy or poor tolerability.The procedure is however associated with the risk of periprocedural events and therefore requires particular attention to systemic anticoagulant thera...

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Main Author: Giuseppe Sgarito
Format: Article
Language:English
Published: AboutScience Srl 2018-09-01
Series:AboutOpen
Subjects:
Online Access:https://journals.aboutscience.eu/index.php/aboutopen/article/view/142
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author Giuseppe Sgarito
author_facet Giuseppe Sgarito
author_sort Giuseppe Sgarito
collection DOAJ
description Transcatheter ablation can be used in case of atrial fibrillation (AF) not controlled by medical therapy due to lack of efficacy or poor tolerability.The procedure is however associated with the risk of periprocedural events and therefore requires particular attention to systemic anticoagulant therapy. In this clinical setting dabigatran may represent a valid therapeutic option to ensure adequate patient protection during the ablation procedure, as demonstrated by the results of the RE-CIRCUIT study. Here we describe an elderly patient, treated for hypertension, with a slightly impaired renal function, a long history of highly symptomatic paroxysmal AF resistant to antiarrhythmic drugs. It describes the common clinical practice prior to the publication of the RE-CIRCUIT study results, which support performing the AF ablation procedure without interrupting the anticoagulant therapy in place with dabigatran. It also highlights the potential efficacy of dabigatran in the treatment of endoauricular thrombus in patients with FA, for whom the currently recommended treatment is bridging with LMWH and the initiation of oral anticoagulant therapy with VKA, which however may be ineffective, as in this case (Diabetology).
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spelling doaj.art-db99d71aeb724b4e8baa7a0fdc6d2ae32022-12-22T02:46:07ZengAboutScience SrlAboutOpen2465-26282018-09-014110.19156/abtpn.2018.0060Atrial fibrillation ablationGiuseppe Sgarito0Aritmologia Interventistica, UOC Cardiologia, ARNAS Ospedale Civico, Palermo - ItalyTranscatheter ablation can be used in case of atrial fibrillation (AF) not controlled by medical therapy due to lack of efficacy or poor tolerability.The procedure is however associated with the risk of periprocedural events and therefore requires particular attention to systemic anticoagulant therapy. In this clinical setting dabigatran may represent a valid therapeutic option to ensure adequate patient protection during the ablation procedure, as demonstrated by the results of the RE-CIRCUIT study. Here we describe an elderly patient, treated for hypertension, with a slightly impaired renal function, a long history of highly symptomatic paroxysmal AF resistant to antiarrhythmic drugs. It describes the common clinical practice prior to the publication of the RE-CIRCUIT study results, which support performing the AF ablation procedure without interrupting the anticoagulant therapy in place with dabigatran. It also highlights the potential efficacy of dabigatran in the treatment of endoauricular thrombus in patients with FA, for whom the currently recommended treatment is bridging with LMWH and the initiation of oral anticoagulant therapy with VKA, which however may be ineffective, as in this case (Diabetology).https://journals.aboutscience.eu/index.php/aboutopen/article/view/142Atrial fibrillationTranscatheter ablationDabigatran
spellingShingle Giuseppe Sgarito
Atrial fibrillation ablation
AboutOpen
Atrial fibrillation
Transcatheter ablation
Dabigatran
title Atrial fibrillation ablation
title_full Atrial fibrillation ablation
title_fullStr Atrial fibrillation ablation
title_full_unstemmed Atrial fibrillation ablation
title_short Atrial fibrillation ablation
title_sort atrial fibrillation ablation
topic Atrial fibrillation
Transcatheter ablation
Dabigatran
url https://journals.aboutscience.eu/index.php/aboutopen/article/view/142
work_keys_str_mv AT giuseppesgarito atrialfibrillationablation