PMID- 29315941
OWN - NLM
STAT- MEDLINE
DCOM- 20191007
LR  - 20191007
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 29
IP  - 4
DP  - 2018 Apr
TI  - Thromboembolic prophylaxis protocol with warfarin after radiofrequency catheter 
      ablation of infarct-related ventricular tachycardia.
PG  - 584-590
LID - 10.1111/jce.13418 [doi]
AB  - INTRODUCTION: Ablation in the left ventricle (LV) is associated with a risk of 
      thromboembolism. There are limited data on the use of specific thromboembolic 
      prophylaxis strategies postablation. We aimed to evaluate a thromboembolic 
      prophylaxis protocol after ventricular tachycardia (VT) ablation. METHODS AND 
      RESULTS: The index procedures of 217 patients undergoing ablation for 
      infarct-related VT with open irrigated-tip catheters were included. Patients with 
      large LV endocardial ablation area (>3 cm between ablation lesions) were started 
      on low-dose, slowly escalating unfractionated heparin (UFH) infusion 8 hours 
      after access hemostasis, followed by 3 months of anticoagulation. Patients with 
      less extensive ablation were treated only with antiplatelet agents postablation. 
      Postablation bridging anticoagulation was used in 181 (83%) patients. Of them, 11 
      (6%) patients experienced bleeding events (1 required endovascular intervention) 
      and 1 (0.6%) experienced lower extremity arterial embolism requiring vascular 
      surgery. Systemic anticoagulation was prescribed in 190 (89%) of 214 patients 
      discharged from the hospital (warfarin in 98%), while the rest received single- 
      or dual-antiplatelet therapy alone. Patients treated with an anticoagulant had 
      significantly longer radiofrequency time compared to patients treated with 
      antiplatelet agents only. One (0.5%) of the patients treated with oral 
      anticoagulation experienced major bleeding 2 weeks postablation. No 
      thromboembolic events were documented in either the anticoagulation or the 
      "antiplatelet only" group postdischarge. CONCLUSION: A slowly escalating bridging 
      regimen of UFH, followed by 3 months of oral anticoagulation, is associated with 
      low thromboembolic and bleeding risks after infarct-related VT ablation. In the 
      absence of extensive ablation, antiplatelet therapy alone is reasonable.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Siontis, Konstantinos C
AU  - Siontis KC
AUID- ORCID: 0000-0002-6658-0971
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
FAU - Jame, Sina
AU  - Jame S
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
FAU - Sharaf Dabbagh, Ghaith
AU  - Sharaf Dabbagh G
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
FAU - Latchamsetty, Rakesh
AU  - Latchamsetty R
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
FAU - Jongnarangsin, Krit
AU  - Jongnarangsin K
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
FAU - Morady, Fred
AU  - Morady F
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
FAU - Bogun, Frank M
AU  - Bogun FM
AUID- ORCID: 0000-0002-0391-7282
AD  - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
LA  - eng
PT  - Journal Article
DEP - 20180125
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Action Potentials
MH  - Aged
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - *Catheter Ablation/adverse effects
MH  - Drug Administration Schedule
MH  - Female
MH  - Heart Rate
MH  - Heart Ventricles/physiopathology/*surgery
MH  - Hemorrhage/chemically induced
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/diagnosis
MH  - Platelet Aggregation Inhibitors/administration & dosage
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Tachycardia, Ventricular/diagnosis/etiology/physiopathology/*surgery
MH  - Thromboembolism/diagnosis/etiology/*prevention & control
MH  - Time Factors
MH  - Treatment Outcome
MH  - Warfarin/*administration & dosage/adverse effects
OTO - NOTNLM
OT  - VT ablation
OT  - anticoagulation
OT  - antiplatelet therapy
OT  - bleeding risk
OT  - stroke
OT  - thromboembolic prophylaxis
EDAT- 2018/01/10 06:00
MHDA- 2019/10/08 06:00
CRDT- 2018/01/10 06:00
PHST- 2017/11/04 00:00 [received]
PHST- 2017/12/22 00:00 [revised]
PHST- 2018/01/02 00:00 [accepted]
PHST- 2018/01/10 06:00 [pubmed]
PHST- 2019/10/08 06:00 [medline]
PHST- 2018/01/10 06:00 [entrez]
AID - 10.1111/jce.13418 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2018 Apr;29(4):584-590. doi: 10.1111/jce.13418. Epub 
      2018 Jan 25.