Uninterrupted versus interrupted direct oral anticoagulation for catheter ablation of atrial fibrillation: A systematic review and meta‐analysis
| العنوان: | Uninterrupted versus interrupted direct oral anticoagulation for catheter ablation of atrial fibrillation: A systematic review and meta‐analysis |
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| المؤلفون: | Rakesh Gopinathannair, Dhanunjaya Lakkireddy, Khawaja Hassan Akhtar, Muhammad Bilal Munir, Ali Jafry, Muhammad Shahzeb Khan, Muhammad Haris Khan, Zain Ul Abideen Asad |
| المصدر: | Journal of Cardiovascular Electrophysiology. |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, medicine.medical_treatment, Administration, Oral, Catheter ablation, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Risk Factors, law, Physiology (medical), Internal medicine, Cardiac tamponade, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Stroke, Randomized Controlled Trials as Topic, business.industry, Anticoagulants, Atrial fibrillation, medicine.disease, Observational Studies as Topic, Relative risk, Meta-analysis, Catheter Ablation, Cardiology, Observational study, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Introduction To evaluate the safety of uninterrupted versus interrupted direct oral anticoagulation (DOAC) for patients undergoing catheter ablation (CA) of atrial fibrillation (AF). Methods We conducted a systematic search of MEDLINE and EMBASE for randomized controlled trials (RCT) and observational studies comparing uninterrupted versus interrupted DOAC for patients undergoing CA of AF. Primary outcome was major bleeding. Secondary outcomes included minor bleeding, stroke or transient ischemic attack (TIA) or thromboembolism (TE), silent cerebral ischemic events, and cardiac tamponade. Meta-analysis was stratified by study design. Risk ratios (RR) with 95% confidence intervals were calculated using random effects model and Mantel-Haenszel method was used to pool RR. Results A total of 13 studies (7 randomized, 6 observational) comprising 3595 patients were included. The RCT restricted analysis did not show any difference in terms of major bleeding (risk ratio [RR] = 0.79; [0.35-1.79]), minor bleeding (RR = 0.99 [0.68-1.43]), stroke or TIA or TE (RR = 0.80 [0.19-3.32]), silent cerebral ischemic events (RR = 0.64 [0.32-1.28]), and cardiac tamponade (RR = 0.61 [0.20-1.92]). Observational study restricted analysis showed a protective effect of uninterrupted DOAC on silent cerebral ischemic events (RR = 0.45 [0.31-0.67]) and no difference in other outcomes. Conclusions There is no difference in bleeding and thromboembolic outcomes with uninterrupted versus interrupted DOAC for CA of AF and observational data suggests that uninterrupted DOACs are protective against silent cerebral ischemic lesions. |
| تدمد: | 1540-8167 1045-3873 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b83a9ad40085112527195edb7fb77bd7Test https://doi.org/10.1111/jce.15043Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....b83a9ad40085112527195edb7fb77bd7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15408167 10453873 |
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