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Over the last few years, uninterrupted warfarin therapy has become standard during atrial fibrillation (AF) ablation. However, wide acceptance of the novel oral anticoagulants has changed the picture. Early reports showed an increased risk for adverse events during AF ablation with dabigatran (NEJM JW Cardiol Feb 29 2012), although later reports were less convincing.
In this prospective, North American study comprising eight centers, 321 patients on rivaroxaban were compared with a control group of 321 on warfarin. All underwent standard radiofrequency ablation. Patients in the rivaroxaban arm underwent transesophageal echocardiography on the day of the procedure to rule out left atrial thrombi. The groups were well matched in all characteri…