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Non-vitamin K Oral Anticoagulants in Hypertrophic Cardiomyopathy Patients Undergoing Catheter Ablation of Atrial Fibrillation
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  • Antonio Creta,
  • Ross Hunter,
  • Mark Earley,
  • Malcolm Finlay,
  • Mehul Dhinoja,
  • Simon Sporton,
  • Anthony Chow,
  • Saidi Mohiddin,
  • Serge Boveda,
  • Pedro Adragão,
  • Zeynab Jebberi,
  • Daniel Matos,
  • Richard Schilling,
  • Pier Lambiase,
  • Rui Providência
Antonio Creta
Barts and The London NHS Trust
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Ross Hunter
St Bartholomew's Hospital
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Mark Earley
Barts Health NHS Trust
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Malcolm Finlay
Barts Health NHS Trust
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Mehul Dhinoja
Barts and The London NHS Trust
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Simon Sporton
Barts Heart Centre, St Bartholomew's Hospital
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Anthony Chow
Barts and The London NHS Trust
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Saidi Mohiddin
Barts and The London NHS Trust
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Serge Boveda
Clinique Pasteur
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Pedro Adragão
Hospital de Santa Cruz, EP Centre Cardiology, Hospital de Santa Cruz
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Zeynab Jebberi
Clinique Pasteur
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Daniel Matos
Hospital de Santa Cruz
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Richard Schilling
Barts and The London NHS Trust
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Pier Lambiase
Barts Heart Centre, Barts Health NHS trust
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Rui Providência
Barts Health NHS Trust
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Peer review status:Published

15 May 2020Submitted to Journal of Cardiovascular Electrophysiology
18 May 2020Submission Checks Completed
18 May 2020Assigned to Editor
19 May 2020Reviewer(s) Assigned
01 Jun 2020Review(s) Completed, Editorial Evaluation Pending
06 Jun 2020Editorial Decision: Revise Minor
14 Jun 20201st Revision Received
15 Jun 2020Submission Checks Completed
15 Jun 2020Assigned to Editor
15 Jun 2020Reviewer(s) Assigned
29 Jun 2020Review(s) Completed, Editorial Evaluation Pending
30 Jun 2020Editorial Decision: Accept
20 Jul 2020Published in Journal of Cardiovascular Electrophysiology. 10.1111/jce.14659

Abstract

Introduction: Patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF) require chronic anticoagulation due to a high thromboembolic risk. Evidence supporting use of non-vitamin K oral anticoagulants (NOACs) in patients with HCM remains sparse, and there are no data regarding the use of NOACs in HCM patients undergoing catheter ablation of AF. Methods: Observational non-randomised study in 4 European Centres. We aimed to investigate the safety and efficacy of NOACs compared with vitamin-K antagonists (VKAs) in patients with HCM undergoing catheter ablation for AF. Results: One hundred thirty-seven HCM patients (mean age 55.0±13.4, 29.1% female) underwent 230 catheter ablations for AF (1.7±1.0 per patient). A total of 55 patients (39.4%) underwent 70 procedures (30.4%) on NOAC, while the remaining were on VKA. Warfarin (97.6%) and rivaroxaban (56.4%) were the most frequently used agents in the respective groups. No procedure-related deaths were reported. We observed no significant difference in the rate of thromboembolism (VKA 0.6%; NOAC 0%; p=1.0) or minor bleeding (VKA 0.6%; NOAC 1.4%; p=0.54). There was a non-significant trend towards a lower incidence of major bleeding (VKA 6.8%; NOAC 1.4%; p=0.09). Conclusion: These preliminary data suggest that NOACs are at least as safe and effective as VKAs in patients with HCM undergoing catheter ablation for AF.