Periprocedural examination and anticoagulant management
Patients scheduled for catheter ablation were admitted the day before
the procedure. At admission, baseline blood testing, echocardiography,
and electrocardiography were performed. All patients underwent standard
transthoracic two-dimensional echocardiography before the procedure.
Left ventricular ejection fraction (LVEF) was analyzed using the biplane
Simpson’s technique. Left atrial diameter (LAD) was assessed using the
M-mode method. For the coagulation marker assessment, blood samples for
each patient were collected the day before ablation, as described
previously.5
The patients received oral anticoagulants at least 3–4 weeks before the
ablation procedure. The attending physician chose direct oral
anticoagulants (DOACs) or warfarin. Each DOAC was prescribed per the
drug package insert (apixaban: 5 or 2.5 mg twice daily; dabigatran: 150
or 110 mg twice daily; rivaroxaban: 15 or 10 mg once daily; and
edoxaban: 60 or 30 mg once daily). The warfarin dose was adjusted to
maintain a therapeutic international normalized ratio of 2.0–3.0 (or
1.6–2.6 for patients ≥70 years old), according to
guidelines.6 The aforementioned anticoagulants were
uninterruptedly administered throughout the
procedure.7