Anticoagulation after typical atrial flutter ablation
- Authors: Bulavina I.A.1, Khamnagadaev I.A.2,3, Khamnagadaev I.I.4, Kokov M.L.5, Troitskiy A.V.6, Zotov A.S.6, Kokov L.S.7,8, Shkolnikova M.A.3
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Affiliations:
- Buyanov City Clinical Hospital
- Endocrinology Research Centre
- The Russian National Research Medical University named after N.I. Pirogov
- Belgorod State National Research University
- Russian State Agrarian University — Moscow Timiryazev Agricultural Academy
- Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency
- Sklifosovsky Research Institute of Emergency Medicine
- Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
- Issue: Vol 14, No 1 (2023)
- Pages: 101-107
- Section: Reviews
- URL: https://journals.rcsi.science/clinpractice/article/view/142810
- DOI: https://doi.org/10.17816/clinpract112089
- ID: 142810
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Abstract
The specifics of the anticoagulant therapy after radiofrequency ablation of the cavotricuspid isthmus have not been sufficiently studied, therefore, the recommendations for prescribing the anticoagulant therapy usually do not distinguish between atrial flutter and atrial fibrillation. In contrast to the case of atrial fibrillation, the effectiveness of the interventional treatment for typical atrial flutter reaches 90%. This procedure may save the patient from a long-term anticoagulant therapy in the absence of recurrence of typical atrial flutter. The decision to stop the anticoagulant therapy after successful radiofrequency ablation of the cavotricuspid isthmus should take into account the potential induction of atrial fibrillation in patients undergoing the interventional treatment. In addition to the CHA2DS2-VASc scale, which characterizes the patient's comorbidity, it is important to take into account the echocardiographic morphofunctional criteria to assess the risk of atrial fibrillation. Currently, this protocol is not regulated in the clinical guidelines. The analysis of the literature data and the authors' own experience allow us to conclude that the optimal time for stopping the anticoagulant therapy is a relapse-free period of 3–4 months after the radiofrequency ablation of the cavotricuspid isthmus, since it is at this time that the effectiveness of the interventional treatment can be objectified.
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##article.viewOnOriginalSite##About the authors
Irina A. Bulavina
Buyanov City Clinical Hospital
Email: doctoroirb@yandex.ru
ORCID iD: 0000-0002-6267-3724
SPIN-code: 1275-2773
MD, cardiologist at cardiac surgery department
Russian Federation, MoscowIgor A. Khamnagadaev
Endocrinology Research Centre; The Russian National Research Medical University named after N.I. Pirogov
Email: i@khamnagadaev.ru
ORCID iD: 0000-0002-9247-4523
SPIN-code: 6338-4990
MD, PhD
Russian Federation, Moscow; MoscowIgor I. Khamnagadaev
Belgorod State National Research University
Email: khamnaga@yandex.ru
ORCID iD: 0000-0001-8541-0364
SPIN-code: 6883-5175
MD, PhD, Professor
Russian Federation, BelgorodMikhail L. Kokov
Russian State Agrarian University — Moscow Timiryazev Agricultural Academy
Email: mikhailkokov@gmail.com
ORCID iD: 0000-0003-4766-5213
врач-рентгенолог, кафедра физиологии растений, МНС
Russian Federation, MoscowAleksandr V. Troitskiy
Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency
Email: dr.troitskiy@gmail.com
ORCID iD: 0000-0003-2143-8696
SPIN-code: 2670-6662
MD, PhD
Russian Federation, 28 Orekhovy boulevard, 115682 MoscowAleksandr S. Zotov
Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency
Author for correspondence.
Email: zotov.alex.az@gmail.com
ORCID iD: 0000-0003-0494-0211
SPIN-code: 9315-6570
MD, PhD
Russian Federation, 28 Orekhovy boulevard, 115682 MoscowLeonid S. Kokov
Sklifosovsky Research Institute of Emergency Medicine; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
Email: lskokov@mail.ru
ORCID iD: 0000-0002-3167-3692
SPIN-code: 1655-5794
MD, PhD, Professor, Academician of the Russian Academy of Sciences
Russian Federation, Moscow; MoscowMaria A. Shkolnikova
The Russian National Research Medical University named after N.I. Pirogov
Email: Arrithmolog@gmail.com
ORCID iD: 0000-0001-7115-0186
SPIN-code: 9051-7107
MD, PhD, Professor
Russian Federation, MoscowReferences
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