PMC:6019327 / 678961-682372
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6019327","sourcedb":"PMC","sourceid":"6019327","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6019327","text":"Recommendation Class LOE References\nPreablation For patients undergoing AF catheter ablation who have been therapeutically anticoagulated with warfarin or dabigatran, performance of the ablation procedure without interruption of warfarin or dabigatran is recommended. I A 400,532,829,830,833,834,837,841\nFor patients undergoing AF catheter ablation who have been therapeutically anticoagulated with rivaroxaban, performance of the ablation procedure without interruption of rivaroxaban is recommended. I B-R 842\nFor patients undergoing AF catheter ablation who have been therapeutically anticoagulated with a NOAC other than dabigatran or rivaroxaban, performance of the ablation procedure without withholding a NOAC dose is reasonable. IIa B-NR 1395\nAnticoagulation guidelines that pertain to cardioversion of AF should be adhered to in patients who present for an AF catheter ablation procedure. I B-NR 5,6\nFor patients anticoagulated with a NOAC prior to AF catheter ablation, it is reasonable to hold one to two doses of the NOAC prior to AF ablation with reinitiation postablation. IIa B-NR 835-840\nPerformance of a TEE in patients who are in AF on presentation for AF catheter ablation and who have been receiving anticoagulation therapeutically for 3 weeks or longer is reasonable. IIa C-EO 5,6\nPerformance of a TEE in patients who present for ablation in sinus rhythm and who have not been anticoagulated prior to catheter ablation is reasonable. IIa C-EO 5,6\nUse of intracardiac echocardiography to screen for atrial thrombi in patients who cannot undergo TEE may be considered. IIb C-EO 768,820-824\nDuring ablation Heparin should be administered prior to or immediately following transseptal puncture during AF catheter ablation procedures and adjusted to achieve and maintain an ACT of at least 300 seconds. I B-NR 768,802-804,820,830,840,846-849\nAdministration of protamine following AF catheter ablation to reverse heparin is reasonable. IIa B-NR 851\nPostablation In patients who are not therapeutically anticoagulated prior to catheter ablation of AF and in whom warfarin will be used for anticoagulation postablation, low molecular weight heparin or intravenous heparin should be used as a bridge for initiation of systemic anticoagulation with warfarin following AF ablation.* I C-EO\nSystemic anticoagulation with warfarin* or a NOAC is recommended for at least 2 months postcatheter ablation of AF. I C-EO 1,2\nAdherence to AF anticoagulation guidelines is recommended for patients who have undergone an AF ablation procedure, regardless of the apparent success or failure of the procedure. I C-EO 5,6\nDecisions regarding continuation of systemic anticoagulation more than 2 months post ablation should be based on the patient’s stroke risk profile and not on the perceived success or failure of the ablation procedure. I C-EO 5,6\nIn patients who have not been anticoagulated prior to catheter ablation of AF or in whom anticoagulation with a NOAC or warfarin has been interrupted prior to ablation, administration of a NOAC 3 to 5 hours after achievement of hemostasis is reasonable postablation. IIa C-EO 835-840\nPatients in whom discontinuation of anticoagulation is being considered based on patient values and preferences should consider undergoing continuous or frequent ECG monitoring to screen for AF recurrence. IIb C-EO","divisions":[{"label":"tr","span":{"begin":0,"end":38}},{"label":"th","span":{"begin":0,"end":14}},{"label":"th","span":{"begin":16,"end":21}},{"label":"th","span":{"begin":23,"end":26}},{"label":"th","span":{"begin":28,"end":38}},{"label":"tr","span":{"begin":39,"end":311}},{"label":"td","span":{"begin":39,"end":50}},{"label":"td","span":{"begin":52,"end":271}},{"label":"td","span":{"begin":273,"end":274}},{"label":"td","span":{"begin":276,"end":277}},{"label":"td","span":{"begin":279,"end":311}},{"label":"tr","span":{"begin":312,"end":523}},{"label":"td","span":{"begin":312,"end":509}},{"label":"td","span":{"begin":511,"end":512}},{"label":"td","span":{"begin":514,"end":517}},{"label":"td","span":{"begin":519,"end":523}},{"label":"tr","span":{"begin":524,"end":766}},{"label":"td","span":{"begin":524,"end":748}},{"label":"td","span":{"begin":750,"end":753}},{"label":"td","span":{"begin":755,"end":759}},{"label":"td","span":{"begin":761,"end":766}},{"label":"tr","span":{"begin":767,"end":928}},{"label":"td","span":{"begin":767,"end":913}},{"label":"td","span":{"begin":915,"end":916}},{"label":"td","span":{"begin":918,"end":922}},{"label":"td","span":{"begin":924,"end":928}},{"label":"tr","span":{"begin":929,"end":1127}},{"label":"td","span":{"begin":929,"end":1106}},{"label":"td","span":{"begin":1108,"end":1111}},{"label":"td","span":{"begin":1113,"end":1117}},{"label":"td","span":{"begin":1119,"end":1127}},{"label":"tr","span":{"begin":1128,"end":1329}},{"label":"td","span":{"begin":1128,"end":1312}},{"label":"td","span":{"begin":1314,"end":1317}},{"label":"td","span":{"begin":1319,"end":1323}},{"label":"td","span":{"begin":1325,"end":1329}},{"label":"tr","span":{"begin":1330,"end":1499}},{"label":"td","span":{"begin":1330,"end":1482}},{"label":"td","span":{"begin":1484,"end":1487}},{"label":"td","span":{"begin":1489,"end":1493}},{"label":"td","span":{"begin":1495,"end":1499}},{"label":"tr","span":{"begin":1500,"end":1644}},{"label":"td","span":{"begin":1500,"end":1619}},{"label":"td","span":{"begin":1621,"end":1624}},{"label":"td","span":{"begin":1626,"end":1630}},{"label":"td","span":{"begin":1632,"end":1644}},{"label":"tr","span":{"begin":1645,"end":1898}},{"label":"td","span":{"begin":1645,"end":1660}},{"label":"td","span":{"begin":1662,"end":1855}},{"label":"td","span":{"begin":1857,"end":1858}},{"label":"td","span":{"begin":1860,"end":1864}},{"label":"td","span":{"begin":1866,"end":1898}},{"label":"tr","span":{"begin":1899,"end":2008}},{"label":"td","span":{"begin":1899,"end":1991}},{"label":"td","span":{"begin":1993,"end":1996}},{"label":"td","span":{"begin":1998,"end":2002}},{"label":"td","span":{"begin":2004,"end":2008}},{"label":"tr","span":{"begin":2009,"end":2347}},{"label":"td","span":{"begin":2009,"end":2021}},{"label":"td","span":{"begin":2023,"end":2338}},{"label":"td","span":{"begin":2340,"end":2341}},{"label":"td","span":{"begin":2343,"end":2347}},{"label":"tr","span":{"begin":2348,"end":2478}},{"label":"td","span":{"begin":2348,"end":2463}},{"label":"td","span":{"begin":2465,"end":2466}},{"label":"td","span":{"begin":2468,"end":2472}},{"label":"td","span":{"begin":2474,"end":2478}},{"label":"tr","span":{"begin":2479,"end":2673}},{"label":"td","span":{"begin":2479,"end":2658}},{"label":"td","span":{"begin":2660,"end":2661}},{"label":"td","span":{"begin":2663,"end":2667}},{"label":"td","span":{"begin":2669,"end":2673}},{"label":"tr","span":{"begin":2674,"end":2906}},{"label":"td","span":{"begin":2674,"end":2891}},{"label":"td","span":{"begin":2893,"end":2894}},{"label":"td","span":{"begin":2896,"end":2900}},{"label":"td","span":{"begin":2902,"end":2906}},{"label":"tr","span":{"begin":2907,"end":3194}},{"label":"td","span":{"begin":2907,"end":3173}},{"label":"td","span":{"begin":3175,"end":3178}},{"label":"td","span":{"begin":3180,"end":3184}},{"label":"td","span":{"begin":3186,"end":3194}},{"label":"td","span":{"begin":3195,"end":3400}},{"label":"td","span":{"begin":3402,"end":3405}}],"tracks":[]}