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A meta-analysis of randomized controlled trials of uninterrupted periprocedural anticoagulation strategy in patients undergoing atrial fibrillation catheter ablation

Research output: Contribution to journalArticle

Yating Zhao, Yao Lu, Yue Qin

Original languageEnglish
JournalInternational Journal of Cardiology
Early online date8 Jun 2018
DOIs
StateE-pub ahead of print - 8 Jun 2018

King's Authors

Abstract

Background In patients undergoing atrial fibrillation (AF) ablation, despite uninterrupted oral anticoagulants (OACs) have been recommended, no consensus has emerged regarding to whether uninterrupted novel oral anticoagulants (NOACs) are superior to uninterrupted vitamin K antagonists (VKAs) for the periprocedural antithrombotic management. This meta-analysis aimed to compare the efficacy and safety of uninterrupted NOACs and uninterrupted VKAs in patients undergoing AF ablation. Methods Databases were searched for articles published up to March 20, 2018. Only randomized controlled trials (RCTs) were selected. The data were analyzed with RevMan 5.3 using a fixed-effects method. Results 6 RCTs and 1903 patients were included. There was no significant difference between NOACs group and VKAs group in incidence of stroke or TIA (OR = 1.00, 95% CI = 0.23–4.40, P = 1.00), silent cerebral thromboembolic events (OR = 1.09, 95% CI = 0.67–1.75, P = 0.74) or minor bleeding (OR = 1.01, 95% CI = 0.78–1.31, P = 0.93), which were consistent in subgroup analysis of individual NOAC vs. VKAs group. NOACs treatment was associated with reduced risk of major bleeding as compared with VKAs (OR = 0.45, 95% CI = 0.26–0.81, P 

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