Complications associated with vascular entry sites are the most common occurrences after catheter ablation of atrial fibrillation. There was a need to determine if a three pronged approach would help in decreasing major vascular complications because of catheter ablation of atrial fibrillation. There is sufficient confirmation about performing the removal of tissue (atrial fibrillation ablation) with the continuous warfarin supervision with a remedial international standard instead of the abridgment with heparin of less weight for some days before and after the procedure. Such an approach decreases the risk of thromboembolic and bleeding issues and does not intensify unfavourable measures although the performance of anticoagulant heightens the risks of bleeding.
However, research has proved that the most advantageous intra-procedural choice for the safe and effective performance of AF ablation without stopping warfarin is quite limited. However, it is quite challenging to keep the INR at remedial levels, especially in patients that are already on medication that work together with the properties of anticoagulants that are administered orally. Since the approval by the FDA of the innovative substances that give chemical reactions such as “dabigatran etexilate” a new period in oral anticoagulation has started because of being included in the international guidelines as a substitute for vitamin K antagonists (VKA) to prevent strokes in patients with AF.
At its RELY testing, it was proved that dabigatran 150 mg BID is an effective substitute for “warfarin” in the treatment of AF who have fewer chances of strokes and systemic embolism, identical chances of massive hemorrhage but most important less intracranial hemorrhaging. Furthermore, the dosage for“dabigatran” is unchanging and does not need anticoagulant checking or the adjustment for the right dose. This is advantageous for patients that require oral anticoagulation and this treatment can benefit a very large number of patients. For these reasons, more people are using dabigatran than any other medicine.
Strokes associated with embolus or embolisms are the deadliest sort of AF ablation, and issues like catheter placement and ablation on the left side of the heart could be a factor of a greater thromboembolic possibility. Therefore, a greater amount of anticoagulation is needed to reduce the risk of clotting of the blood during the procedure, despite the possibility of more bleeding. Several studies have been carried out for the use of the recent anticoagulant in the background of AF ablation, and analysis have shown major-minor bleeding and thromboembolic difficulties when compared with continuous warfarin treatment which has shown different outcomes