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Conventional oral anticoagulation may not replace prior transesophageal echocardiography for the patients with planned catheter ablation for atrial fibrillation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Instruction

Preablation transesophageal echocardiography (TEE) is dispensable for the patients with planned catheter ablation for atrial fibrillation (AF) and having received at least a 3-week oral anticoagulation therapy according to the recommendations of the Venice Consensus. But the role of prior TEE and the effect of preablation short-term oral anticoagulation drugs (OACs) under the circumstance are still unclear.

Methods and Results

A total of 188 patients with planned catheter ablation for AF and without previous long-term oral anticoagulation, whose duration of AF exceeded 48 h, were randomly divided into receiving 3-week OACs (OACs group) before heparin bridging or receiving no prior OACs (N-OACs group). Follow-up was performed until a TEE had been performed on all the cases before ablation. Consequently, the prevalence of atrial thrombi is 6.3% and 11.7%, respectively (P < 0.05), and the prevalence of minor bleeding is 5.3% and 0%, respectively (P < 0.05), in OACs and N-OACs group. There was no thrombotic event, major hemorrhage, in both groups.

Conclusion

After a 3-week effective oral anticoagulation, atrial thrombi could be resolved partly but not completely in the patients with AF who had not received long-term oral anticoagulation previously. To ensure safety, prior TEE may be necessary for the patients with planned catheter ablation for AF.

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Acknowledgments

This work was supported by the Beijing Anzhen Hospital, Capital University of Medical Sciences, and Beijing Institute of Heart Lung and Blood Vessel Diseases. We thank Dr Guangxia Wei for her valuable suggestions regarding echocardiography.

Funding

This work was supported by grants from Beijing “Ten, hundred and thousand” Medical Talented Man Project Special Fund (NO 06-003).

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Anzhen Li, Chaoyang District, Beijing, 100029, People’s Republic of China

    Hua He, Junping Kang, Hailong Tao, Bin Zhen, Ming Zhang, Deyong Long & Jianzeng Dong

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  1. Hua He
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  2. Junping Kang
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  3. Hailong Tao
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Correspondence to Hua He.

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He, H., Kang, J., Tao, H. et al. Conventional oral anticoagulation may not replace prior transesophageal echocardiography for the patients with planned catheter ablation for atrial fibrillation. J Interv Card Electrophysiol 24, 19–26 (2009). https://doi.org/10.1007/s10840-008-9322-2

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  • DOI: https://doi.org/10.1007/s10840-008-9322-2

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