Safety and efficacy of dabigatran etexilate during catheter ablation of atrial fibrillation: A meta-analysis of the literature

Abstract

AimsTo summarize and analyse the published literature on the efficacy and safety of dabigatran for anticoagulation during atrial fibrillation (AF) ablation.Methods and resultsA comprehensive search of the literature in the English language was conducted and 10 studies were identified which compared dabigatran therapy with warfarin. Data were extracted and meta-analysed using appropriate methodology. There was significant clinical heterogeneity among studies concerning study designs and methodologies. Most studies consisted of retrospective single-centre observational studies. A total of 3648 patients were included of whom 2241 were receiving warfarin and 1407 dabigatran. Only 12 thrombo-embolic events were reported, 3 during warfarin and 9 during dabigatran therapy [odds ratio (OR) 2.38, 95% confidence interval (CI) 0.82-6.85, P = n.s.). The pooled rate of major bleeding events was similar for warfarin and for dabigatran (OR 1.05, 95% CI 0.62-1.80; P = n.s.). Rates of minor bleeding events were also similar between the two treatment groups.ConclusionDabigatran has similar efficacy and safety compared with warfarin when used for periprocedural anticoagulation during AF ablation. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved.