• Roger Dillier, Sonia Ammar, Gabriele Hessling, Bernhard Kaess, Herribert Pavaci, Alessandra Buiatti, Verena Semmler, Susanne Kathan, Monika Hofmann, Carsten Lennerz, Christof Kolb, Tilko Reents, and Isabel Deisenhofer.
• From the Department of Cardiovascular Diseases in Adults, German Heart Center Munich, Technical University, Munich, Germany. roger.dillier@bluewin.ch.
• Circ Arrhythm Electrophysiol. 2014 Aug 1; 7 (4): 576-82.

BackgroundThis study aimed to evaluate the safety of continuous periprocedural rivaroxaban administration during left atrial radiofrequency ablation (RFA) in comparison with uninterrupted oral vitamin K antagonist administration. Data about the use of rivaroxaban in the setting of left atrial RFA procedures are lacking.Methods And ResultsThe study cohort included 544 patients (mean age, 63±10 years) who underwent left atrial RFA procedures between February 2012 and May 2013. All patients (n=272) receiving uninterrupted periprocedural rivaroxaban 15 or 20 mg/d before the procedure (rivaroxaban) were matched by age, sex, and type of rhythm disorder with an equal number of patients managed with uninterrupted vitamin K antagonist phenprocoumon (international normalized ratio, 2-3). During RFA, heparin was given intravenously to maintain an activated clotting time at 270 to 300 s. The safety end point was a composite of bleeding, thromboembolic events, and death. There were no thromboembolic complications and no deaths in either group. The prevalence of major bleeding complications was similar in both groups (1 tamponade in RivG and 1 groin hematoma requiring transfusion in phenprocoumon). Minor bleeding complications occurred equally in both groups (20 of 272; 7% in the rivaroxaban versus 33 of 272, 12% in the phenprocoumon; P=0.08). In multivariable analyses, female sex was associated with a greater risk of complications (odds ratio, 1.96; 95% confidence interval, 1.10-3.49).ConclusionsIn patients undergoing left atrial RFA, continuous periprocedural rivaroxaban use seems to be as safe as uninterrupted periprocedural phenprocoumon administration.© 2014 American Heart Association, Inc.

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