According to a recent study presented by the European Society of Cardiology and Cardiostim, patients suffering from atrial fibrillation (AFib) may be able to safely continue taking some types of blood thinners as they undergo surgery to correct the heart rhythm problem. People with AFib typically take blood thinners, also called anticoagulants, to prevent the development of blood clots that can break free and cause strokes.
The Standard Process
There are two main types of blood thinners – Warfarin and Novel Oral Anticoagulants (NOACs). Patients usually take the blood thinners for a month before catheter ablation then stop taking the anticoagulant a few days before the procedure to reduce the risk for excessive bleeding during the surgical procedure. Unfortunately, stopping either of these medications could be leaving patients at risk for developing blood clots, known as thromboembolism.
Details of the Study
At Ehra Europace – Cardiostim 2015, Dr Carsten Wunderlich, senior consultant in the Department of Invasive Electrophysiology, Heart Centre Dresden, Germany, presented his findings on the study. He noted that clinicians at his center had followed the protocol of withholding NOACs and, as the result, two patients suffered thromboembolism, and one had a stroke.
The medical professionals then decided to continue NOAC therapy during future catheter ablations and study what happened.
The researchers created a study of 549 consecutive patients with drug refractory AF scheduled for catheter ablation at Heart Center Dresden. Of these patients, 233 were taking warfarin or warfarin-like drugs and 316 were taking NOACs.
All patients continued taking their anticoagulation drugs through the catheter ablation procedure. The researchers performed echocardiography, a type of heart test that looks for pericardial effusion, or fluid around the heart. The scientists followed up with participants for six months.
The result of the study was that not one patient in either group suffered an embolism or stroke, which is extremely good news. This suggests that patients may be able to use NOACs during catheter ablation for AFib without an increased risk for bleeding during the procedure or embolism afterwards.
It’s important to note, however, that the researchers conducted the study in a high volume healthcare institution with a heart surgery center on site. More research is certainly necessary to determine whether stopping NOACs before ablation is appropriate for all medical facilities offering cardiac ablation. Further research could forever change the way patients take anticoagulants before cardiac ablation.
Only your doctor can determine what the best plan is to treat your AFib. Be sure to talk to your cardiologist to learn more about your options for anticoagulants leading up to your catheter ablation. If your cardiologist recommends you see an EP doctor (electrophysiologist), contact us today. Dr. Dilip Mathew has performed countless catheter ablation, and has been serving the Sun Coast since 2004. Contact him to schedule an appointment today.