Clinical outcomes of bridging therapy with fondaparinux versus low-molecular-weight heparin in patients undergoing atrial fibrillation ablation
10.3969/j.issn.1673-4254.2014.04.02
- VernacularTitle:心房颤动导管射频消融术桥接使用磺达肝癸钠或低分子肝素的临床结局
- Author:
Feifei ZHANG
1
;
Donghua ZHAO
;
Xinhui PENG
;
Hao YANG
;
Tingyan ZHU
;
Fumei HUANG
;
Jian PENG
Author Information
1. 南方医科大学南方医院心内科
- Keywords:
fondaparinux;
low-molecular-weight heparin;
atrial fibrillation;
catheter ablation;
anticoagulation
- From:
Journal of Southern Medical University
2014;(4):448-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of bridging therapy with fondaparinux versus low-molecular-weight heparin (LMWH) in patients undergoing radiofrequency ablation for atrial fibrillation (AF). Methods AF patients undergoing radiofrequency ablation between January, 2009 and June, 2013 in Nanfang Hospital were analyzed. The patients received subcutaneous injection of either fondaparinux or LMWH as a bridging therapy during warfarin discontinuation 5 days before the ablation until a post-ablation international normalized ratio (INR) of 2.0-3.0 was achieved. Anticoagulant-related complications, identified and classified as thromboembolic and bleeding events, were compared between the two groups. Results A total of 465 patients (68%male;mean age 52.3±15 years, range 25 to 80 years) were enrolled in the study, including 265 in fondaparinux group and 200 in LMWH group. Anticoagulation-related complications were observed in 3 patients in fondaparinux group, as compared with 13 in LMWH group (P=0.002), but the thromboembolic rate did not differ significantly between the two groups (P=0.111). Two patients in fondaparinux group and 8 in LMWH group showed bleeding complications (P=0.039). No cardiovascular death occwrred in these patients during a mean follow-up period of 3 months. Conclusions Fondaparinux as the bridging therapy during catheter ablation for AF does not increase the risk of thromboembolic complications but slightly reduces the risk of bleeding compared to LMWH, suggesting its safety and effectiveness for periprocedural anticoagulation management in AF patients undergoing radiofrequency ablation.
