Efficacy and Safety of Anticoagulant Therapy in Patients With Various Forms of Atrial Fibrillation After Interventional Treatment. Results of a Three-Year Follow-up

Aim      To evaluate efficacy and safety of the anticoagulant therapy in patients with atrial fibrillation (AF) during a 36-month follow-up after an interventional treatment.

Material and methods  This study included 302 patients aged 29 to 81 years with various forms of AF. Catheter ablation (CA) of AF foci was performed for all patients. The patients were divided into 3 groups: group 1 with paroxysmal AF, group 2 with persistent AF, and group 3 with longstanding persistent AF. Two subgroups were isolated in each group, with effective and ineffective CA. Results of the follow-up were analyzed at 12, 24, and 36 months after discharge from the hospital. The follow-up interview recorded complaints of palpitation attacks, effectiveness of administered CA, compliance with the treatment, adverse clinical outcomes, including thromboembolic complications (TEC), bleeding, and hospitalizations.

Results Efficacy of the interventional treatment for 36 months was 65.3 % in patients with paroxysmal AF, 59.7 % in patients with persistent AF, and 57.1 % in patients with longstanding persistent AF. Patients with paroxysmal AF and effective CA had no adverse events throughout the same period during the antithrombotic treatment (ATT). In contrast, the group with ineffective ablation had both TEC and hemorrhagic complications during the ATT. In the group with persistent AF and effective CA throughout the follow-up period, TECs were less frequent than in the group of ineffective ablations during the ATT treatment. Patients with longstanding persistent AF and effective CA throughout the follow-up period, had no TECs in contrast to patients with ineffective ablation during the ATT treatment. There were no fatal outcomes in patients with effective procedure.

Conclusion      A successful CA procedure for AF provides a significant decrease in the risk of ischemic stroke. Furthermore, the invasive strategy does not increase the risk of major and minor bleedings.

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