ABC | Volume 114, Nº3, March 2020

Original Article Silva et al. AF ablation with rivaroxaban Arq Bras Cardiol. 2020; 114(3):435-442 1. Calkins H, Hindricks G, Cappato R, KimYH, Saad EB, Aguinaga L, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECEexpertconsensusstatementoncatheter and surgical ablation of atrial fibrillation: Executive summary. Heart Rhythm. 2017;14(10):e445-94. 2. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace. 2016;18(11):1609-78. 3. Di Biase L, Burkhardt JD, Santangeli P, Mohanty P, Sanchez JE, Horton R, et al. Periprocedural stroke and bleeding complications in patients undergoingcatheterablationofatrialfibrillationwithdifferentanticoagulation management: results from the role of Coumadin in preventing thromboembolism in atrial fibrillation (AF) patients undergoing catheter ablation(COMPARE)RandomizedTrial.Circulation.2014;129(25):2638-44. 4. Santangeli P, Di Biase L, Horton R, Burkhardt JD, Sanchez J, Al-Ahmad A, et al. Ablation of atrial fibrillation under therapeutic warfarin reduces periprocedural complications evidence from a meta-analysis. Circulation: Arrhythm Electrophysiol. 2012;5(2):302-11. 5. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, DeenadayaluN, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants withwarfarin inpatientswithatrial fibrillation:ameta-analysisofrandomised trials. Lancet. 2014;383(9921):955-62. 6. Cappato R, Marchlinski FE, Hohnloser SH, Naccarelli GV, Xiang J, Wilber DJ, et al. Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial fibrillation. Eur Heart J. 2015;36(28):1805-11. 7. Schulman S, Kearon C, Subcommitee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostaticmedicinal products in non-surgical patients. J Thromb Haemost. 2005;3(4):692-4. 8. Gautam S, John RM, Stevenson WG, Jain R, Epstein LM, Tedrow U, et al. Effect of therapeutic INR on activated clotting times, heparin dosage, and bleeding risk during ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(3):248-54. 9. Bassiouny M, Saliba W, Rickard J, Shao M, Sey A, Diab M, et al. Use of dabigatran for peri-procedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol. 2013;6(3):460-6. 10. Yamaji H, Murakami T, Hina K, Higashiya S, Kawamura H, Murakami M, et al. Adequate initial heparin dosage for atrial fibrillation ablation in patients receiving non-vitamin K antagonist oral anticoagulants. Clin Drug Investig. 2016;36(10):837-48. 11. SilvaMA, Elias Neto J, Merçon ES, FuturoG, Kuniyoshi R. Ablação por cateter da FA sob uso ininterrupto de rivaroxabana (“abstract”). Arq Brasil Cardiol. 2017; 109(Suppl 2):27. 12. Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, et al. 2012 HRS/EHRA/ECAS 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart RhythmAssociation (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart RhythmAssociation, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society.. Heart Rhythm. 2012;9(4):632-96. 13. Di Biase L, Gaita F, Toso E, Santangeli P, Mohanty P, Rutledge N, et al. Does periprocedural anticoagulation management of atrial fibrillation affect the prevalence of silent thromboembolic lesion detected by diffusion cerebral magnetic resonance imaging in patients undergoing radiofrequency atrial fibrillation ablationwith open irrigated catheters? Results froma prospective multicenter study. Heart Rhythm. 2014;11(5):791-8. 14. Lakkireddy D, Reddy YM, Di Biase L, Vanga SR, Santangeli P, Swarup V, et al. Feasibility and safety of dabigatran versus warfarin for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation: results fromamulticenter prospective registry. J AmColl Cardiol. 2012;59(13):1168-74. 15. Lakkireddy D, Reddy YM, Di Biase L, Vallakati A, Mansour MC, Santangeli P, et al. Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial brillation: results fromamulticenter prospective regis- try. J AmColl Cardiol. 2014;63(10):982-8. References in these procedures. Conclusions Radiofrequency ablation of atrial fibrillation under uninterrupted rivaroxaban use was safe, with low rates of thromboembolic or hemorrhagic complications when compared with the conventional strategy of uninterrupted warfarin anticoagulation. Author contributions Conception and design of the research: Silva MA, Elias Neto J, Kuniyoshi R; Acquisition of data: Silva MA, Futuro GMC, Merçon ES, Vasconcelos D, Agrizzi RS, Elias Neto J, Kuniyoshi R; Analysis and interpretation of the data and Statistical analysis: Silva MA; Writing of the manuscript: Silva MA, Elias Neto J; Critical revision of the manuscript for intellectual content: Futuro GMC, Merçon ES, Elias Neto J. Potential Conflict of Interest Márcio Augusto Silva - Participation in courses and congresses by Bayer and lectures paid by Bayer and Daiichi Sankyo. Jorge Elias Neto - Participation in courses and congresses by Bayer. Ricardo Kuniyoshi - Participation in courses and congresses by Bayer Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 441