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