Effect of uninterrupted dabigatran or rivaroxaban on achieving ideal activated clotting time to heparin response during catheter ablation in patients with atrial fibrillation  

作　　者：Qian XIN Chuang ZHANG Yu-Jia WANG Jian LI Tao CHEN Shi-Xing LI Wei WANG Yu YANG Wen-Juan SONG Jin ZHOU Xiang-Min SHI 

机构地区：[1]Department of Cardiology,the Sixth Medical Centre,Chinese PLA General Hospital,Beijing,China [2]Department of Health Service,the Eighth Medical Centre,Chinese PLA General Hospital,Beijing,China

出　　处：《Journal of Geriatric Cardiology》2022年第8期565-574,共10页老年心脏病学杂志（英文版）

基　　金：supported by the Chinese PLA Special Research on Health Care (17BJZ08)

摘　　要：BACKGROUND Uninterrupted use of oral anticoagulants before atrial fibrillation(AF)ablation can reduce the incidence of perioperative thromboembolic events.However,the effect of new oral anticoagulants on activated clotting time(ACT)in respo-nse to heparin during AF ablation in Chinese populations remains unknown.The aim of the present retrospective study was to investigate the value of ACTs in response to intraoperative heparin administration in patients using dabigatran or rivaroxaban.METHODS From January 2018 to December 2021,a total of 173 patients undergoing AF ablation were included in the study,in which 101 patients were treated with dabigatran,72 patients were treated with rivaroxaban.The intraoperative ACT values were examined in both groups.The incidence of periprocedural complications was evaluated.RESULTS Initial heparin dosage(88±19 U/kg vs.78±27 U/kg,P<0.05),total heparin dosage(137±41 U/kg vs.106±52 U/kg,P<0.05)during the ablation procedure were higher in the dabigatran group than those in the rivaroxaban group.Mean ACT(280±36 s vs.265±30 s,P<0.05),and the percentage of ACTs within the therapeutic range(250-350 s)(74%±26%vs.60%±29%,P<0.05)were significantly lower in the dabigatran group than those in the rivaroxaban group,particularly in male pati-ents.Furthermore,the average time of achieving the target ACT(250-350 s)was also found longer in the dabigatran group(P<0.05)as compared with the rivaroxaban group.No significant difference was found in the incidence of periprocedural complica-tions between the two groups.CONCLUSIONS The anticoagulant effect of uninterrupted rivaroxaban therapy appears to be more stable and efficient than dabigatran administration during catheter ablation in patients with AF.

关 键 词：PATIENTS HEPARIN DOSAGE 

分 类 号：R541.75[医药卫生—心血管疾病]