Efficacy and safety of uninterrupted low ‐intensity warfarin for cryoballoon ablation of atrial fibrillation in the elderly: A pilot study

This study aimed to evaluate the efficacy and safety of uninterrupted low‐intensity warfarin for CB‐A of AF in the elderly. MethodsParoxysmal AF patients (age ≥ 70 years) who underwent CB‐A were enrolled prospectively. The participants were stratified into 2 groups based on international normalized ratio (INR) before ablation (INR in group A: 1.5 to 2.0; INR in group B: 2.0‐2.5). Primary endpoints included periprocedural thromboembolic complications and major bleeding. Secondary endpoints were new asymptomatic cerebral emboli (ACE) and minor bleeding. Results and discussionA total of 144 patients were enrolled (group A: 65; group B: 79). In group A, the use of concomitant antiplatelet drugs was more common. Also, the mean HAS‐BLED score was significantly higher (2.4 ± 0.8 vs 2.0 ± 0.6, P < .01) and the mean activated clotting time (ACT) during the procedure was significantly lower (302 ± 14 s vs 311 ± 11 s, P < .01). Other clinical characteristics were balanced between the 2 groups. No thromboembolic complications and major bleeding occurred in either group. The incidence of periprocedural ACE was comparable between the 2 groups (9.2% vs 6.3%, P = .74). The incidence of minor bleeding in group A and group B was 4.6% and 11.4%, respectively (P = .14). What is new and conclusionCompared with standard‐intensity warfarin, uninterrupted low‐intensity warfarin might not increase the incidence of thromboembolic complications and might be as...
Source: Journal of Clinical Pharmacy and Therapeutics - Category: Drugs & Pharmacology Authors: Tags: ORIGINAL ARTICLE Source Type: research