publication . Article . 2019

Heparin dosing in uninterrupted anticoagulation with dabigatran vs. warfarin in atrial fibrillation ablation: RE-CIRCUIT study

Hugh Calkins; Stephan Willems; Atul Verma; Richard J. Schilling; Stefan H. Hohnloser; Ken Okumura; Matias Nordaby; Eva Kleine; Branislav Bis; Edward P. Gerstenfeld;
Open Access
  • Published: 01 Apr 2019 Journal: EP Europace, volume 21, pages 879-885 (issn: 1099-5129, eissn: 1532-2092, Copyright policy)
  • Publisher: Oxford University Press (OUP)
Abstract
Abstract Aims To describe heparin dosing requirements in patients who underwent catheter ablation of atrial fibrillation with uninterrupted anticoagulation using dabigatran etexilate (dabigatran) or warfarin to attain therapeutic activated clotting time (ACT) in the RE-CIRCUIT® study. The RE-CIRCUIT study showed significantly fewer major bleeding events in the dabigatran vs. warfarin treatment group. Unfractionated heparin was administered during the procedure to maintain ACT >300 s. Methods and results Patients were randomly assigned to dabigatran 150 mg bid or international normalized ratio-adjusted warfarin. Ablation was performed with uninterrupted ant...
Persistent Identifiers
Subjects
SDG: 3. Good health
free text keywords: Physiology (medical), Cardiology and Cardiovascular Medicine, Clinical Research, Ablation for Atrial Fibrillation, Atrial fibrillation, Anticoagulation, Catheter ablation, Dabigatran, Heparin dosing, Warfarin, Dabigatran, medicine.drug, medicine, Anesthesia, Heparin, Dosing, Warfarin, Atrial fibrillation, medicine.disease, business.industry, business, Activated clotting time, medicine.diagnostic_test, Ablation, medicine.medical_treatment, Catheter ablation
Download fromView all 2 versions
Open Access
EP Europace
Article . 2019
Open Access
EP Europace
Article . 2019
Provider: Crossref
20 references, page 1 of 2

1 Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA et al 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace 2012;14:528–606.22389422 [PubMed]

2 January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JCJ et al 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014;64:e1–76.24685669 [PubMed]

3 Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B et al 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 2016;18:1609–78.27567465 [OpenAIRE] [PubMed]

4 Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L et al 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace 2018;20:e1–160. [OpenAIRE]

5 Di Biase L, Burkhardt JD, Santangeli P, Mohanty P, Sanchez JE, Horton R et al Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial fibrillation with different anticoagulation management: results from the role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial. Circulation 2014;129:2638–44.24744272 [OpenAIRE] [PubMed]

6 Page SP, Siddiqui MS, Finlay M, Hunter RJ, Abrams DJ, Dhinoja M et al Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance?J Cardiovasc Electrophysiol 2011;22:265–70.21040095 [PubMed]

7 Calkins H, Willems S, Gerstenfeld EP, Verma A, Schilling R, Hohnloser SH et al Uninterrupted dabigatran versus warfarin for ablation in atrial fibrillation. N Engl J Med 2017;376:1627–36.28317415 [PubMed]

8 Calkins H, Brugada J, Packer DL, Cappato R, Chen SA, Crijns HJ et al HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm Society. Europace 2007;9:335–79.17599941 [PubMed]

9 Chen J, Todd DM, Hocini M, Larsen TB, Bongiorni MG, Blomstrom-Lundqvist C.Current periprocedural management of ablation for atrial fibrillation in Europe: results of the European Heart Rhythm Association Survey. Europace 2014;16:378–81.24569891 [PubMed]

10 van Ryn J, Stangier J, Haertter S, Liesenfeld KH, Wienen W, Feuring M et al Dabigatran etexilate—a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost 2010;103:1116–27.20352166 [PubMed]

11 Yamaji H, Murakami T, Hina K, Higashiya S, Kawamura H, Murakami M et al Adequate initial heparin dosage for atrial fibrillation ablation in patients receiving non-vitamin K antagonist oral anticoagulants. Clin Drug Investig 2016;36:837–48.

12 Bassiouny M, Saliba W, Rickard J, Shao M, Sey A, Diab M et al Use of dabigatran for periprocedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol 2013;6:460–6.23553523 [OpenAIRE] [PubMed]

13 Nagao T, Inden Y, Yanagisawa S, Kato H, Ishikawa S, Okumura S et al Differences in activated clotting time among uninterrupted anticoagulants during the periprocedural period of atrial fibrillation ablation. Heart Rhythm 2015;12:1972–8.25881495 [PubMed]

14 Konduru SV, Cheema AA, Jones P, Li Y, Ramza B, Wimmer AP.Differences in intraprocedural ACTs with standardized heparin dosing during catheter ablation for atrial fibrillation in patients treated with dabigatran vs. patients on uninterrupted warfarin. J Interv Card Electrophysiol 2012;35:277–84.23015216 [OpenAIRE] [PubMed]

15 Calkins H, Gerstenfeld EP, Schilling R, Verma A, Willems S.RE-CIRCUIT study-randomized evaluation of dabigatran etexilate compared to warfarin in pulmonary vein ablation: assessment of an uninterrupted periprocedural anticoagulation strategy. Am J Cardiol 2015;115:154–5.

20 references, page 1 of 2
Any information missing or wrong?Report an Issue