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A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban
BACKGROUND: The feasibility and safety of pulmonary vein isolation (PVI) using cryoballoon (CB) for paroxysmal atrial fibrillation (PAF) with minimally interrupted apixaban has not fully explored. METHODS: In this multicenter, randomized prospective study, we enrolled patients with PAF undergoing CB...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411193/ https://www.ncbi.nlm.nih.gov/pubmed/32782630 http://dx.doi.org/10.1002/joa3.12392 |
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author | Yagishita, Atsuhiko Goya, Masahiko Iesaka, Yoshito Nitta, Junichi Takahashi, Atsushi Nagata, Yasutoshi Hachiya, Hitoshi Inaba, Osamu Inamura, Yukihiro Tanaka, Yasuaki Watanabe, Keita Tao, Susumu Shirai, Yasuhiro Yamamoto, Tasuku Shiohira, Shinya Akiyoshi, Kikou Sekigawa, Masahiro Maeda, Shingo Sasaki, Takeshi Takahashi, Yoshihide Kawabata, Mihoko Hirao, Kenzo |
author_facet | Yagishita, Atsuhiko Goya, Masahiko Iesaka, Yoshito Nitta, Junichi Takahashi, Atsushi Nagata, Yasutoshi Hachiya, Hitoshi Inaba, Osamu Inamura, Yukihiro Tanaka, Yasuaki Watanabe, Keita Tao, Susumu Shirai, Yasuhiro Yamamoto, Tasuku Shiohira, Shinya Akiyoshi, Kikou Sekigawa, Masahiro Maeda, Shingo Sasaki, Takeshi Takahashi, Yoshihide Kawabata, Mihoko Hirao, Kenzo |
author_sort | Yagishita, Atsuhiko |
collection | PubMed |
description | BACKGROUND: The feasibility and safety of pulmonary vein isolation (PVI) using cryoballoon (CB) for paroxysmal atrial fibrillation (PAF) with minimally interrupted apixaban has not fully explored. METHODS: In this multicenter, randomized prospective study, we enrolled patients with PAF undergoing CB or radiofrequency (RF) ablation with interrupted (holding 1 dose) apixaban. The primary composite end point consisted of bleeding events, including pericardial effusion and major bleeding requiring blood transfusion, or thromboembolic events at 4 weeks after ablation; secondary end points included early recurrence of AF and procedural duration. RESULTS: A total of 250 patients underwent PVI (125 assigned to the RF ablation and 125 assigned to the CB ablation). The primary end point occurred in 1 patient in the CB ablation group (0.8%; 90% confidence interval [CI], 0.04 to 3.70) and 3 patients in the RF group (2.4%, P = .622; risk ratio, 0333; 90% CI, 0.05 to 2.20). All events were pericardial effusion, all of whom recovered after pericardiocentesis. Early recurrence of AF occurred in 4 patients (3.2%) in the RF group and in 6 patients (4.8%) in the CB group (P = .749). The procedural duration was shorter in the CB group than that in the RF group (136.5 ± 39.9 vs 179.5 ± 44.8 min, P < .001). CONCLUSION: CB ablation with minimally interrupted apixaban was feasible and safe in patients with PAF undergoing PVI, which was equivalent to RF ablation. |
format | Online Article Text |
id | pubmed-7411193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74111932020-08-10 A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban Yagishita, Atsuhiko Goya, Masahiko Iesaka, Yoshito Nitta, Junichi Takahashi, Atsushi Nagata, Yasutoshi Hachiya, Hitoshi Inaba, Osamu Inamura, Yukihiro Tanaka, Yasuaki Watanabe, Keita Tao, Susumu Shirai, Yasuhiro Yamamoto, Tasuku Shiohira, Shinya Akiyoshi, Kikou Sekigawa, Masahiro Maeda, Shingo Sasaki, Takeshi Takahashi, Yoshihide Kawabata, Mihoko Hirao, Kenzo J Arrhythm Original Articles BACKGROUND: The feasibility and safety of pulmonary vein isolation (PVI) using cryoballoon (CB) for paroxysmal atrial fibrillation (PAF) with minimally interrupted apixaban has not fully explored. METHODS: In this multicenter, randomized prospective study, we enrolled patients with PAF undergoing CB or radiofrequency (RF) ablation with interrupted (holding 1 dose) apixaban. The primary composite end point consisted of bleeding events, including pericardial effusion and major bleeding requiring blood transfusion, or thromboembolic events at 4 weeks after ablation; secondary end points included early recurrence of AF and procedural duration. RESULTS: A total of 250 patients underwent PVI (125 assigned to the RF ablation and 125 assigned to the CB ablation). The primary end point occurred in 1 patient in the CB ablation group (0.8%; 90% confidence interval [CI], 0.04 to 3.70) and 3 patients in the RF group (2.4%, P = .622; risk ratio, 0333; 90% CI, 0.05 to 2.20). All events were pericardial effusion, all of whom recovered after pericardiocentesis. Early recurrence of AF occurred in 4 patients (3.2%) in the RF group and in 6 patients (4.8%) in the CB group (P = .749). The procedural duration was shorter in the CB group than that in the RF group (136.5 ± 39.9 vs 179.5 ± 44.8 min, P < .001). CONCLUSION: CB ablation with minimally interrupted apixaban was feasible and safe in patients with PAF undergoing PVI, which was equivalent to RF ablation. John Wiley and Sons Inc. 2020-06-27 /pmc/articles/PMC7411193/ /pubmed/32782630 http://dx.doi.org/10.1002/joa3.12392 Text en © 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Yagishita, Atsuhiko Goya, Masahiko Iesaka, Yoshito Nitta, Junichi Takahashi, Atsushi Nagata, Yasutoshi Hachiya, Hitoshi Inaba, Osamu Inamura, Yukihiro Tanaka, Yasuaki Watanabe, Keita Tao, Susumu Shirai, Yasuhiro Yamamoto, Tasuku Shiohira, Shinya Akiyoshi, Kikou Sekigawa, Masahiro Maeda, Shingo Sasaki, Takeshi Takahashi, Yoshihide Kawabata, Mihoko Hirao, Kenzo A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban |
title | A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban |
title_full | A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban |
title_fullStr | A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban |
title_full_unstemmed | A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban |
title_short | A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban |
title_sort | prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: j‐hit apixaban |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411193/ https://www.ncbi.nlm.nih.gov/pubmed/32782630 http://dx.doi.org/10.1002/joa3.12392 |
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