Catheter-Based Ablation Case Studies

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with a significant impact in morbidity and mortality (1). One of the well-established treatments for symptomatic atrial fibrillation is catheter-based ablation (2). AF ablation is a complex interventional procedure associated with potential risk of thromboembolic complications as periprocedural stroke or transient ischemic attack (TIA) and cardiac tamponade (1, 2). Approximately, from 0 to 7 % of AF patients undergoing ablation suffer from thromboembolic complications (3). Management of systemic anticoagulation before, during, and after ablation is essential to minimize the risk of these complications but it also could potentially increase the risk of bleeding events (1, 2). Therefore, maintaining balance between bleeding and thrombosis is the target to prevent cerebrovascular events. …show more content…
Warfarin administration, which is a vitamin K antagonist, has been the primary precept for AF ablation anticoagulation as it is associated with lower risk of bleeding and stroke, while a new oral anticoagulant called Dabigatran, which is a non-vitamin K antagonist, has showed safety and efficacy outcomes similar or superior to those of warfarin regarding periprocedual stroke prevention (2). Furthermore, an evidence favor dabigatran over warfarin as it has an advantage of not requiring regular monitoring. However, the major concern of performing catheter ablation with Dabigatran is the risk of bleeding, particularly life-threatening bleeding (1,