JACC in a Flash: NOACs and Outcomes Following Cardioversion and AF Ablation

JACC in a Flash: 3/1/14

In patients with atrial fibrillation (AF), anticoagulation strategies must be carefully selected—taking into consideration the risk of bleeding and thromboembolic events and the interaction with potential treatments to correct cardiac arrhythmias. Three novel oral anticoagulant (NOAC) drugs have been approved for stroke prevention in these patients over the last few years, each demonstrating at least a level of noninferiority to warfarin, the old standard. Two new studies published in JACC evaluated the risk of complications with rivaroxaban or apixaban therapy, compared to warfarin, during and after procedures to correct AF-related arrythmias.

Rivaroxaban Versus Warfarin

In the first, primary co-authors Dhanunjaya Lakkireddy, MD, and Yeruva Madhu Reddy, MD, from the Blood Heart Rhythm Center at University of Kansas Hospital in Kansas City, performed a multicenter, observational study from a prospective registry of patients undergoing AF ablation in eight centers across the United States. A total of 642 patients were included in the study—321 had uninterrupted preiprocedural rivaroxaban, and an equal number received uninterrupted warfarin therapy.