{"id":"f97c4792b3b6","type":"article","url":"https://hartvaat.nl/2019/02/01/ononderbroken-versus-onderbroken-doac-bij-af-ablatie-prospectieve-trial/","title":"Ononderbroken versus onderbroken DOAC bij AF-ablatie: prospectieve trial","title_en":"Uninterrupted vs. interrupted periprocedural direct oral anticoagulants for catheter ablation of atrial fibrillation: a prospective randomized single-centre study on post-ablation thrombo-embolic and haemorrhagic events.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["apotheker","cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euy148","source_url":"https://doi.org/10.1093/europace/euy148","authors":["Kohki Nakamura","Shigeto Naito","Takehito Sasaki","Yutaka Take","Kentaro Minami","Yoshiyuki Kitagawa","Hiroyuki Motoda","Mitsuho Inoue","Yoshimitsu Otsuka","Katsura Niijima","Eiji Yamashita","Yoshinao Sugai","Koji Kumagai","Keiko Koyama","Nobusada Funabashi","Shigeru Oshima"],"significance":6,"published":"2019-02-01","source_date":"2019-02-01","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"This prospective randomized trial compared uninterrupted versus interrupted DOAC therapy during catheter ablation for AF, providing safety data for periprocedural anticoagulation management in the direct oral anticoagulant era.","created":"2026-07-03T10:27:45Z","updated":"2026-07-03T13:26:58Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Prospectieve trial die ononderbroken versus onderbroken DOAC vergeleek bij katheterablatie voor AF. Veiligheidsdata voor periprocedureel DOAC-beleid.","abstract_original":"AIMS: This prospective, randomized, single-centre study aimed to directly compare the safety and efficacy of uninterrupted and interrupted periprocedural anticoagulation protocols with direct oral anticoagulants (DOACs) in patients undergoing catheter ablation of non-valvular atrial fibrillation (NVAF). METHODS AND RESULTS: We randomly assigned 846 NVAF patients receiving DOACs prior to ablation to uninterruption (n = 422) or interruption (n = 424) of the DOACs on the day of the procedure. The primary endpoint was a composite of symptomatic thromboembolisms and major bleeding events within 30 days after the ablation. Secondary endpoints included symptomatic and silent thromboembolisms and major and minor bleeding events. The primary endpoint occurred in 0.7% of the uninterrupted DOAC group [1 transient ischaemic attack (TIA) and 2 major bleeding events] and 1.2% of the interrupted DOAC group (1 TIA and 4 major bleeding events) (P = 0.480). The incidence of major and minor bleeding was comparable between the two groups (0.5% vs. 0.9%, P = 0.345; 5.9% vs. 5.4%, P = 0.753). Silent cerebral ischaemic lesions (SCILs) were observed in 138 (20.9%) of the 661 patients undergoing post-ablation magnetic resonance (MR) imaging. The uninterrupted and interrupted DOAC groups revealed a similar incidence of SCILs (19.8% vs. 22.0%, P = 0.484) and percentage of SCILs with disappearance on follow-up MR imaging (77.8% vs. 82.1%, P = 0.428). CONCLUSION: Both the uninterrupted and interrupted DOAC protocols revealed a low risk of symptomatic thromboembolisms and major bleeding events and similar incidence of SCILs and minor bleeding events and may be feasible for periprocedural anticoagulation in NVAF patients undergoing catheter ablation."}