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New Oral Anticoagulant Versus Vitamin K Antagonists for Thoracoscopic Ablation in Patients with Persistent Atrial Fibrillation: A Randomized Controlled Trial

Semin Thorac Cardiovasc Surg. 2021 Dec 5:S1043-0679(21)00494-9. doi: 10.1053/j.semtcvs.2021.12.003. Online ahead of print.

ABSTRACT

Anticoagulation could not be currently stopped even after successful thoracoscopic ablation of atrial fibrillation for at least two months. The aim of this study is to compare the safety and efficacy outcomes between a new oral anticoagulant and warfarin after thoracoscopic ablation. This trial was a single-center, prospective, randomized controlled study comparing edoxaban and warfarin in patients undergoing thoracoscopic ablation of atrial fibrillation. This study enrolled 60 patients randomly assigned into two groups. The primary endpoint was efficacy outcomes, including stroke and systemic thromboembolic events. The secondary endpoint was safety outcomes including major bleeding and pericarditis. The patients were evaluated at discharge, two weeks, three months, and six months postoperatively. No stroke and thromboembolic events were noted in both treatment groups during the follow-up period. During the 6 months follow-up period, 4 (13%) of 30 patients in the edoxaban group experienced minor bleeding events, whereas none were noted in the warfarin group. Five anticoagulation-related events (bleeding, and prolongation of international normalized ratio), including pericarditis, were noted in both the edoxaban and warfarin groups. No statistically significant difference existed between the two groups. In conclusion, this study showed the comparable results of edoxaban to warfarin during the window period of post-thoracoscopic ablation of atrial fibrillation. Moreover, anticoagulation-related events were rather affected by patient factors and not by the anticoagulant type.

PMID:34879226 | DOI:10.1053/j.semtcvs.2021.12.003

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