- 著者
- Akihiko Nogami Takashi Kurita Haruhiko Abe Kenji Ando Toshiyuki Ishikawa Katsuhiko Imai Akihiko Usui Kaoru Okishige Kengo Kusano Koichiro Kumagai Masahiko Goya Yoshinori Kobayashi Akihiko Shimizu Wataru Shimizu Morio Shoda Naokata Sumitomo Yoshihiro Seo Atsushi Takahashi Hiroshi Tada Shigeto Naito Yuji Nakazato Takashi Nishimura Takashi Nitta Shinichi Niwano Nobuhisa Hagiwara Yuji Murakawa Teiichi Yamane Takeshi Aiba Koichi Inoue Yuki Iwasaki Yasuya Inden Kikuya Uno Michio Ogano Masaomi Kimura Shun-ichiro Sakamoto Shingo Sasaki Kazuhiro Satomi Tsuyoshi Shiga Tsugutoshi Suzuki Yukio Sekiguchi Kyoko Soejima Masahiko Takagi Masaomi Chinushi Nobuhiro Nishi Takashi Noda Hitoshi Hachiya Masataka Mitsuno Takeshi Mitsuhashi Yasushi Miyauchi Aya Miyazaki Tomoshige Morimoto Hiro Yamasaki Yoshifusa Aizawa Tohru Ohe Takeshi Kimura Kazuo Tanemoto Hiroyuki Tsutsui Hideo Mitamura on behalf of the JCS/JHRS Joint Working Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-20-0637, (Released:2021-06-01)
- 参考文献数
- 1350
- 被引用文献数
- 75
- 著者
- Akihiko Nogami Kyoko Soejima Itsuro Morishima Kenichi Hiroshima Ritsushi Kato Satoru Sakagami Fumiharu Miura Keisuke Okawa Tetsuya Kimura Takashi Inoue Atsushi Takita Kikuya Uno Koichiro Kumagai Takashi Kurita Masahiko Gosho Kazutaka Aonuma for the RYOUMA Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-22-0290, (Released:2022-08-20)
- 参考文献数
- 41
- 被引用文献数
- 7
Background: Optimal periprocedural oral anticoagulant (OAC) therapy before catheter ablation (CA) for atrial fibrillation (AF) and the safety profile of OAC discontinuation during the remote period (from 31 days and up to 1 year after CA) have not been well defined.Methods and Results: The RYOUMA registry is a prospective multicenter observational study of Japanese patients who underwent CA for AF in 2017–2018. Of the 3,072 patients, 82.3% received minimally interrupted direct-acting OACs (DOACs) and 10.2% received uninterrupted DOACs. Both uninterrupted and minimally interrupted DOACs were associated with an extremely low thromboembolic event rate. Female, long-standing persistent AF, low creatinine clearance, hepatic disorder, and high intraprocedural heparin dose were independent factors associated with periprocedural major bleeding. At 1 year after CA, DOAC was continued in 55.9% of patients and warfarin in 56.4%. The incidence of thromboembolic and major bleeding events for 1 year was 0.3% and 1.2%, respectively. Age ≥73 years, dementia, and AF recurrence were independently associated with major bleeding events. Univariate analyses revealed that warfarin continuation and off-label overdose of DOACs were risk factors for major bleeding after CA.Conclusions: High intraprocedural dose of heparin was associated with periprocedural major bleeding events. At 1 year after CA, over half of the patients had continued OAC therapy. Thromboembolic events were extremely low; however, major bleeding occurred in 1.2%. Age ≥73 years, dementia, and AF recurrence were independently associated with major bleeding after CA.