| ² 박지한, ¹ 반지은, ¹ 박예민, ¹ 이대인, ¹ 김미나, ¹ 박환철, ¹ 최종일, ¹ 박상원, ¹ 김영훈 |
Background:The purpose of this study was to investigate the safety and efficacy of standard anticoagulation(SA) over 3 months after radiofrequency catheter ablation(RFCA) of atrial fibrillation(AF) in comparison with the early-stopped warfarinization(EW) within 3 months. Methods:We compared safety between SA(n=50) and EW(n=59)group in 109 patients who underwent RFCA of AF(78 males,55.9±11years old,paroxysmal AF 59.6%,CHADS2 score 1.4±0.9,duration of follow up 693.1±234.6 days,duration of AF 46.7±42.5 months) Results:The prevalence of hypertension,diabetes mellitus or stroke were not different between 2 groups. Antiarrhythmic drugs was used similarly in both groups. Among the patients, the mean CHADS2 score (1.5±0.9 vs 1.4±0.8, P=NS) were not different between 2 groups. In laboratory findings, the plasma levels of total protein, albumin, and creatinine were not different between the 2 groups. LA diameter and LV ejection fraction were not significantly different between SA and EW groups. Compared to EW group, uninterrupted preprocedural warfarinization(62.0% vs 33.9%, P=0.004) was greater in SA group, therefore, INR value(1.47±0.51 vs 1.14±0.28, P=0.002) at the procedure was higher. The plasma levels of hemoglobin(1.44±1.7 vs 1.34±2.0, P=0.017) and hematocrit(42.6±4.7 vs 39.6±5.8, P=0.021) were lower in SA group. However, the incidence of hemorrhagic complications (11.9% vs 6.0%, P=NS) or the thromboembolic events (1.7% vs 0.0%, P=NS) was not different between two groups. Conclusion:In patients with low to intermediate risk of thromboembolism(mean CHADS2 1.5),early-stopped warfarinization within 3 months after RFCA of AF had comparable safety with warfarinization over 3 months. Further prospective study in large scale is warranted to determine long-term safety of each anticoagulation strategy.
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