{"id":"3ee2d9072802","type":"article","url":"https://hartvaat.nl/2021/01/27/periprocedurele-antistolling-bij-eliminate-af-ononderbroken-edoxaban-versus-vka/","title":"Periprocedurele antistolling bij ELIMINATE-AF: ononderbroken edoxaban versus VKA","title_en":"Periprocedural anticoagulation in the uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation (ELIMINATE-AF) trial.","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/euaa199","source_url":"https://doi.org/10.1093/europace/euaa199","authors":["Stefan H Hohnloser","A John Camm","Riccardo Cappato","Hans-Christoph Diener","Hein Heidbüchel","Lluís Mont","Carlos A Morillo","Hans-Joachim Lanz","Heiko Rauer","Paul-Egbert Reimitz","Rüdiger Smolnik","Josef Kautzner"],"significance":5,"published":"2021-01-27","source_date":"2021-01-27","image":"","kennis":[],"congress":"","summary_en":"This ELIMINATE-AF subanalysis characterized heparin dosing requirements and procedure-related bleeding during AF ablation with uninterrupted edoxaban versus VKA, informing periprocedural anticoagulation management.","created":"2026-07-03T10:29:01Z","updated":"2026-07-03T13:28:09Z","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":"ELIMINATE-AF subanalyse naar periprocedurele antistolling bij AF-ablatie met edoxaban versus VKA.","abstract_original":"AIMS: This post hoc analysis of ELIMINATE-AF evaluated requirements of unfractionated heparin (UFH) and procedure-related bleeding in atrial fibrillation (AF) patients undergoing ablation with uninterrupted edoxaban or vitamin K antagonist (VKA) therapy. METHODS AND RESULTS: Patients were randomized 2:1 to once-daily edoxaban 60 mg (or dose-reduced 30 mg) or dose-adjusted VKA (target international normalized ratio: 2.0-3.0). Uninterrupted anticoagulation was mandated for 21-28 days' pre-ablation and 90 days' post-ablation. During ablation, UFH administration targeted an activated clotting time (ACT) of 300-400 s. Periprocedural bleeding was differentiated between procedure-related (bleeding at puncture side, cardiac tamponade) and unrelated events. Of 614 randomized patients, 553 received study drug and underwent catheter ablation (edoxaban n = 375; VKA n = 178). The median (Q1-Q3) time from last dose to ablation procedure was 14.8 (13.3-16.5) vs. 16.5 (14.8-19.5) h (edoxaban vs. VKA group, respectively). Mean ACT (SD) ≥300 s was observed in 52% edoxaban- vs. 76% VKA-treated patients, despite a higher mean (SD) UFH dose in the edoxaban vs. VKA group [14 261 (6397) IU vs. 11 473 (4300) IU; exploratory P-value < 0.0001]. In the edoxaban group, 13 patients (3.5%) had procedure-related bleeds of whom 9 had received an UFH dose above the median (13 000 IU). In the VKA arm, 7 patients (3.9%) had procedure-related bleeds of whom 3 had received an UFH dose above the median (10 225 IU). CONCLUSION: The rate of procedure-related major/clinically relevant non-major bleeding did not differ between the treatment arms despite higher doses of UFH used with edoxaban vs. VKA to achieve a target ACT during AF ablation."}