华法林在低栓塞风险的心房颤动患者射频消融术后的应用

目的探讨消融治疗获得成功的持续性心房颤动患者,特别是栓塞风险低的个体,术后是否需要继续应用华法林抗凝治疗。方法入选低危栓塞风险的持续性心房颤动患者107例,射频消融术后随机分为华法林治疗组(55例)和非华法林组(52例),华法林治疗组患者术后服用华法林治疗至少3个月,抗凝治疗强度为INR2.0～3.0;非华法林组只服用阿司匹林,每日100mg。所有患者术后均进行随访,观察比较两组患者血栓栓塞和出血事件发生率的差异。结果所有患者均成功完成射频消融术,即刻成功率为100%。两组患者术中均未发生栓塞或出血事件。随访6～18个月,华法林组发生血栓栓塞事件2例(3.6%),非华法林组发生2例(3.7%),两组患者栓塞发生率无统计学差异,P>0.1。华法林组有3例(5.5%)出血事件,非华法林组无出血事件发生。结论对于射频消融取得成功的低危心房颤动患者,可以考虑不应用华法林抗凝,而只服用阿司匹林。

The Application of Therapy with Warfarin in Low-risk Patients after Atrial Fibrillation Ablation

Objective To success of ablation in patients with persistent atrial fibrillation, especially in low-risk individuals embolism, the need to continue after use of warfarin for anticoagulation. Methods A total of 107 consecutive patients who underwent ablation procedures for symptomatic AF were evaluated. Outcomes were compared between patients treated with warfarin （n=55, goal INR： 2~3） versus aspirin only （n=52, 100mg/day） in CHADS2 0~1 patients after ablation. Results During following up, the incidence of embolism in patients treated with warfarin were 3.6%,versus 3.7% in patients treated with aspirin only. There is no difference between two groups （P 0.1）. There were 3（5.5%） hemorrhage events in patients treated with warfarin while no any hemorrhage events happened in patients treated with aspirin. Conclusion Selected low-risk patients who undergo atrial fibrillation ablation can safely be discharged following their procedure on aspirin alone.