Arrhythmias & electrophysiology
Peri-procedural anticoagulation in patients with end-stage kidney disease undergoing atrial fibrillation ablation: results from the multicentre end-stage kidney disease–atrial fibrillation ablation registry
Authors' conclusion
Despite most patients with ESKD undergoing AF ablation showing undertreatment with warfarin, major bleeding events are common while thromboembolic events are rare.
Study context
- Population
- Patients with end-stage kidney disease (ESKD) on haemodialysis undergoing catheter ablation for atrial fibrillation (AF)
- Participants
- 307 patients347 procedures
- Outcome
- Peri-procedural anticoagulation management (INR before and after ablation)
- Follow-up
- Before and 1 and 3 months after ablation
Methodological details12 referral centres in Japan
- 12 referral centres in Japan
Main finding
As reported in the abstract
INR
International normalized ratio (INR) before ablation, median (IQR 1.20-2.00)
1.58
INR at 1 month (IQR 1.22-2.02)
1.54
INR at 3 months (IQR 1.01-1.71)
1.22
Observational data: associations, not effects.
Further findings
Predictor of major bleeding: pre-procedural INR ≥2.0
| OR (CI) | P value | ||
|---|---|---|---|
| Pre-procedural INR ≥2.0Only independent predictor | 3.3 (1.2–8.7) | P = 0.018 | |
| 0.10.31310Odds ratio (log scale) |
Safety
- Major complications
- 35 patients (10%)
- Major bleeding
- 19 patients; 5.4%
- Cardiac tamponade
- 11 (3.2%)
- Peri-procedural deaths, both bleeding-related
- two (0.6%)
- No cerebral or systemic thromboembolism occurred
- Pre-procedural INR ≥2.0 only independent predictor of major bleeding: OR 3.3 (1.2-8.7), P = 0.018
Original publication
Peri-procedural anticoagulation in patients with end-stage kidney disease undergoing atrial fibrillation ablation: results from the multicentre end-stage kidney disease–atrial fibrillation ablation registry. Europace. Published 9 March 2023. doi:10.
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