Dabigatran Associated with Increased Bleeding During Atrial Fibrillation Ablation

In warfarin recipients with therapeutic international normalized ratios (INRs), uninterrupted warfarin treatment during radiofrequency ablation for atrial fibrillation (AF) has relatively convincingly been shown to reduce both thromboembolic and bleeding events. Dabigatran is increasingly prescribed as an alternative to warfarin in patients with nonvalvular AF. However, dabigatran's half life ranges from 12 to 14 hours and is prolonged in patients with renal insufficiency. Given the lack of an antidote to reverse its effects, the drug's safety and efficacy during ablation are not clear.

Investigators used prospective data from a multicenter registry to compare the results of AF ablation in 145 patients taking dabigatran with the results in a…