Catheter ablation is a standard treatment for patient with symptomatic and drugrefractory atrial fibrillation. As for every invasive approach, ablation is associated with certain risk of complications. About 2-3% of adverse events are related to hemorrhage or thromboembolism. Therefore, periprocedural anticoagulation scheme is of paramount importance to minimize the risk of both types of complications. Here we describe the factors, associated with thromboembolic and bleeding risks, and the evolving approaches for periprocedural anticoagulation treatment. Special attention is paid to uninterrupted oral anticoagulation and potential role of reverse agent in management of procedure-related hemorrhages.
Aim. The results presented, of subanalysis of the catheter ablation (CA) registry in atrial fibrillation (AF) with the patients properties, specifics of CA and treatment results, in Russia comparing to European countries. Material and methods. During 2012 to 2015, totally 3742 patients included to the registry, of those 477 in Russia. In 467 Russian patients (males 56,5%; mean age 58,5 y. o.) CA AF was done. During one year 392 patients were followed up. Minimum requirements to follow-up: routine ECG registration and non less than one contact after 12 months passed. Results. In Russian patients there were more common obesity (46,1% and 29,2%, pu003c0,001), hypertension heart disease (40,2% and 22,8%, pu003c0,0001), coronary heart disease (31,7% and 16,2%, pu003c0,0001), chronic heart failure (67,3% and 13,0%, pu003c0,0001). In Russia the patients more commonly underwent primary CA (83,5% in Russia and 77,6% in European countries, pu003c0,05), more rare in Russia the cryoballoon ablation was done (3% and 18%, pu003c0,05). Generally adverse events were reported more rare in Russia (10,5% and 16,6%, p=0,0007), including cardiovascular adverse events (2,6% and 5,2%, pu003c0,05). Tachiarrhythmias recurs were diagnosed more rare in Russia, including by the subsutaneous ECG monitors (17% and 1,6% in other countries, рu003c0,001). Within the year of follow-up, full absence of tachiarrhythmias recurs in Russia was found in 65,8% of patients, in other countries — in 74,7% (р=0,0003). Conclusion. In real clinical setting, high efficacy of CA AF was shown, resistant to antiarrhythmic therapy. In most of Russian patients there were cardiovascular comorbidities. There was lower rate of reported adverse events in Russian centers of interventional treatments.
Aim. The results presented, of subanalysis of the catheter ablation (CA) registry in atrial fibrillation (AF) with the patients properties, specifics of CA and treatment results, in Russia comparing to European countries.Material and methods. During 2012 to 2015, totally 3742 patients included to the registry, of those 477 in Russia. In 467 Russian patients (males 56,5%; mean age 58,5 y. o.) CA AF was done. During one year 392 patients were followed up. Minimum requirements to follow-up: routine ECG registration and non less than one contact after 12 months passed.Results. In Russian patients there were more common obesity (46,1% and 29,2%, p<0,001), hypertension heart disease (40,2% and 22,8%, p<0,0001), coronary heart disease (31,7% and 16,2%, p<0,0001), chronic heart failure (67,3% and 13,0%, p<0,0001). In Russia the patients more commonly underwent primary CA (83,5% in Russia and 77,6% in European countries, p<0,05), more rare in Russia the cryoballoon ablation was done (3% and 18%, p<0,05). Generally adverse events were reported more rare in Russia (10,5% and 16,6%, p=0,0007), including cardiovascular adverse events (2,6% and 5,2%, p<0,05). Tachiarrhythmias recurs were diagnosed more rare in Russia, including by the subsutaneous ECG monitors (17% and 1,6% in other countries, р<0,001). Within the year of follow-up, full absence of tachiarrhythmias recurs in Russia was found in 65,8% of patients, in other countries — in 74,7% (р=0,0003).Conclusion. In real clinical setting, high efficacy of CA AF was shown, resistant to antiarrhythmic therapy. In most of Russian patients there were cardiovascular comorbidities. There was lower rate of reported adverse events in Russian centers of interventional treatments.