One-Day Interruption of NOAC Is Associated with Low Risk of Periprocedural Adverse Events during Pulmonary Vein Isolation If Combined with Left Atrial Thrombus Exclusion with Computed Tomography
Katalin Piros,
Adorján Vida,
Nándor Szegedi,
Péter Perge,
Zoltán Salló,
Arnold Béla Ferencz,
Vivien Klaudia Nagy,
Szilvia Herczeg,
Pál Ábrahám,
Csaba Csobay-Novák,
Zsófia Drobni,
Tamás Tahin,
Györgyi Apponyi,
Béla Merkely,
László Gellér,
István Osztheimer
Affiliations
Katalin Piros
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Adorján Vida
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Nándor Szegedi
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Péter Perge
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Zoltán Salló
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Arnold Béla Ferencz
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Vivien Klaudia Nagy
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Szilvia Herczeg
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Pál Ábrahám
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Csaba Csobay-Novák
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Zsófia Drobni
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Tamás Tahin
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Györgyi Apponyi
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Béla Merkely
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
László Gellér
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
István Osztheimer
Heart and Vascular Center, Semmelweis University, Városmajor Street 68, 1122 Budapest, Hungary
Background: Safety, efficacy, and patient comfort are the expectations during pulmonary vein isolation (PVI). We aimed to validate the combined advantages of pre- and periprocedural anticoagulation with non-vitamin K anticoagulants (NOACs) and rigorous left atrial appendage thrombus (LAAT) exclusion with computed tomography (CT). Methods: This study included a population of consecutive patients, between March 2018 and June 2020, who underwent cardiac CT within 24 h before PVI to guide the ablation and rule out LAAT. NOAC was omitted 24 h before the ablation. Results: A total of 187 patients (63% male) underwent CT before PVI. None of the patients experienced stroke during or after the procedure. The complication rate was low, with no thromboembolic events and 2.1% of patients experiencing a major bleeding event. Conclusions: Omitting NOAC 24 h before the ablation might be safe if combined with left atrial thrombus exclusion with computed tomography.
