Introduction
Methods
Inclusion Criteria
Exclusion Criteria
Data Extraction
Study End Points
Statistical Analysis
Compliance with Ethics Guidelines
Results
Study | Year | Publication/meeting | Sample size (NOACs, W) | Mean age [years; (NOACs, W)] | Females,% (NOACs, W) | PAF (%; NOACs, W) | Type of procedure | CHADS2 score (NOACs, W) | HAS-BLED score (NOACs, W) | NOACs: drug, dose (mg) | NOACs held | Warfarin |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Arshad [15] | 2013 | HRS | 298, 153 | 60.7 ± 10 | 28 | 67a
| Abl. | 1.3 ± 1.0 | 2.8 ± 1.0 | D 150 | Held 12 h pre-procedure and resumed on post-procedure night | Uninterrupted |
Bassiouny [16] | 2013 | Circ EP | 376, 623 | 59, 63 | 25, 27 | 57, 55 | Abl. | – | – | D 150 | 1–2 doses held before procedure resumed at conclusion of the procedure | Uninterrupted |
Bernard [17] | 2013 | ACC | (155, 75)b, 44 | (63, 63)b, 67 | – | (46, 57)b, 50 | Abl. | – | – | D 150, R | Held within 24 h pre-procedure and restarted within 24 h post-procedure | Uninterrupted |
Ellis [18] | 2012 | HRS | 61, 110 | – | – | – | Abl. | 1.2 ± 0.2 | – | D 150, R | Held 12–48 h pre-procedure, resumed within 4–24 h after sheath pull | Subtherapeutic INR bridged with heparin |
Gadiyaram [19] | 2013 | HRS | 54, 128 | 62.7 | 24, 24 | – | Abl. | – | – | R | Held 2 days before ablation, one dose of lovenox 6 h after hemostasis was achieved and R was resumed the next day | Uninterrupted |
Haines [20] | 2013 | JICE | 202, 202 | 60.2, 59.7 | 26, 31 | 55, 50 | Abl. | 1.6 ± 1.3, 1.9 ± 1.4c
| – | D 150 (1 patient received D 110) | 17% received D within 12 h before the procedure, D resumed within 24 h | Therapeutic pre-procedure INR in 80%, remaining bridged with lovenox |
Ichiki [21] | 2013 | PACE | 30, 180 | 57, 60 | 17, 22 | 70, 30 | Abl. | 1.1 ± 1.1, 1.0 ± 1.0 | – | D 110–13 patients, D 150–17 | Discontinued only on the morning of the procedure, resumed from the evening | Uninterrupted |
Imamura [22] | 2013 | JICE | 101, 126 | 61, 62 | 25, 30 | 44, 51 | Abl. | 0.9 ± 0.9, 1.1 ± 1.0 | 0.7 ± 0.8, 1.0 ± 0.9 | D 110/D 150 depending on patient’s condition | Held 12–24 h before and restarted 3 h after the procedure | Warfarin was stopped 3 days before the procedure and unfractionated heparin was administered |
Kaiser [23] | 2013 | JICE | 122, 135 | 58, 64 | 36, 32 | 69, 47 | LAA abl. | 1.2 ± 1, 1.6 ± 1 | – | D 150 | Held 24–30 h pre-procedure and restarted 4–6 h after hemostasis was achieved | Uninterrupted |
Kaseno [24] | 2012 | Circulation Journal | 110, 101 | – | – | – | Abl. | – | – | D 110 | Held on the morning of the procedure, and resumed on the next morning | Uninterrupted |
Khan [25] | 2013 | ACC | 50, 66 | 56.3, - | 39 | – | Abl. | 1.06, - | – | D 150 | Last dose held 24 h prior to the procedure and restarted 6 h after sheath removal | Uninterrupted |
Kim [26] | 2013 | Heart Rhythm | 191, 572 | 61, 61 | 20, 26 | 53, 48 | Abl. | 1.0 ± 0.9, 1.1 ± 1.0 | 1.0 ± 0.9, 1.1 ± 1.0 | D 150 | Held after the morning dose on the day before the procedure and resumed 4 h after hemostasis was achieved | Uninterrupted |
Konduru [37] | 2012 | JICE | 24, 52 | 56.6, 60.9 | 21, 33 | 21, 44 | Abl. | – | – | D 150 | Continued without interruption (first 11 patients) or held 2 doses immediately prior to the procedure (last 13 patients). D was continued the evening following the procedure | Uninterrupted |
Lakkireddy [27] | 2013 | JACC | 145, 145 | 60.4, 60.3 | 21, 21 | 57, 57 | Abl. | 1.6 ± 1.4, 1.5 ± 1.3c
| 1.2 ± 0.9, 1.1 ± 0.9 | D 150 | Held on the morning of the procedure, resumed within 3 h after hemostasis | Uninterrupted |
Lakkireddy [38] | 2014 | JACC | 321, 321 | 63, 63 | 31, 31 | 49, 49 | Abl. | 1.16 ± 1.0, 1.18 ± 1.0 | 1.47 ± 0.9, 1.70 ± 1.0 | R 15, 20 | Uninterrupted | Uninterrupted |
Maddox [28] | 2013 | JCE | 212, 251 | 62.3, 62.5 | 24, 33 | 63, 57 | Abl. | 0.92 ± 0.88, 0.92 ± 0.85 | D 150 | Morning dose on the day of the ablation procedure; post-procedural dabigatran was administered on the evening of the procedure | Uninterrupted | |
Mendoza [29] | 2012 | HRS | 60, 58 | 62.9, 64.0 | 10, 12 | Abl. | 1.32, 1.29 | 1.47, 1.63 | D 150 | Held only the morning of the procedure and resumed immediately after sheath removal | Uninterrupted | |
Mohajer [30] | 2013 | Canadian Journal of Cardiology | 43, 95 | 60, 63 | – | 69.8, 41.1 | Abl. | 0.6 ± 0.7, 0.9 ± 0.9 | – | D 150 (D 110 in 3 patients) | Held 24 h prior to procedure | Uninterrupted |
Nin [31] | 2013 | PACE | 45, 45 | 61, 61 | 16, 20 | 34, 32 | Abl. | – | – | D 110 | Held on morning of the procedure and resumed 4 h after hemostasis | Uninterrupted |
Pavaci [39] | 2012 | ESC | 27, 27 | – | – | – | Abl. | – | – | – | – | – |
Rowley [40] | 2012 | HRS | 113, 169 | 63 | – | – | Abl. | 1.3 ± 1 | – | – | Last dose the day before AF ablation and typically restarted the day following ablation | Bridged with enoxaparin |
Snipelisky [32] | 2012 | JICE | 31, 125 | 60.6, 64.6 | 19.4, 25.6 | 68, 46 | Abl. | 0.84, 1.22 | – | D 150 | Held the dose on the morning of the procedure | Uninterrupted |
Snipelisky [41] | 2014 | HRS | 56, 25, 48 | – | – | – | Abl. | – | – | D, R | – | – |
Stepanyan [33] | 2014 | JICE | 89, 98, 114 | 59, 60, 62.9 | 42, 34, 33 | 70, 81, 64 | Abl. | – | – | D, R | The last dose of D was given the morning 1 day prior to the procedure, and the last dose of R was given the evening 2 days prior. Bridged with heparin NOAC was resumed at 8:00 a.m. on the morning after the procedure | Uninterrupted |
Tao [34] | 2014 | HRS | 70, 70 | 66 | 30 | 73 | Abl. | – | – | R 10, 15 | Uninterrupted | Uninterrupted |
Ueno [35] | 2014 | HRS | 79, 15, 45 | 61 | 25 | – | Abl. | – | – | D, R | – | – |
Yamaji [36] | 2013 | Clinical Drug Inv. | 106, 106 | 60, 61 | 25, 24 | 65, 64 | Abl. | 1.8 ± 1.6, 1.7 ± 1.6 | – | D 110 (36), D 150 (70) | Held on the day of procedure, resumed 3 h after the completion | Uninterrupted |