Peri-Procedural Anticoagulation and Imaging
Catheter ablation in patients treated with warfarin was performed
without interruption. Patients treated with direct oral anticoagulants
(DOACs) held anticoagulation for a maximum of 24 h prior to the ablation
procedure, with resumption 4 h post-procedure. Anticoagulation was
continued for a minimum of 3 months following ablation for all patients.
Patients underwent routine transesophageal echocardiography (TEE)
immediately prior to ablation to exclude LAA thrombus unless TEE was
clinically contraindicated. Patients unable to undergo preprocedural TEE
were systemically anticoagulated for at least one month prior to
ablation. Additionally, patients underwent pre-procedure cardiac CT or
MRI to delineate left atrial anatomy. Electroanatomic mapping (EAM) data
collected during the procedure was merged with the pre-acquired CT or
MRI at the operator’s discretion.