The purpose of the present study was to compare the efficacy and safety of dabigatran
and interrupted warfarin with low-molecular-weight heparin bridging in non-valvular
atrial fibrillation (AF) catheter ablation. Previously, there has been concerns that
bridging therapy increases bleeding events without the benefit of stroke prevention.
It has been suggested that bridging therapy should be considered only for patients
at high-risk of thrombosis. Nevertheless, bridging therapy in AF patients with a low
CHADS2 score may be safe and effective. The authors performed a prospective, observational
study that included consecutive 240 patients undergoing AF ablation in P.R. China.
A total of 139 patients received 110 mg dabigatran twice daily and 101 patients took
dose-adjusted warfarin that had been bridged with low-molecular-weight heparin. The
mean patient age was 55.48 years with 72.1% being men and 74.2% having paroxysmal
AF. One thromboembolic complication occurred in the dabigatran group compared to none
in the warfarin group. Both the groups presented a similar major bleeding rate, total
bleeding rate, and bleeding and thromboembolic complications. In patients undergoing
AF ablation, the risk of bleeding or thromboembolic complications was similar for
both dabigatran and interrupted warfarin with bridging therapy. Bridging therapy appeared
to be safe and effective for the low-risk population.