{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T16:07:47Z","timestamp":1762445267533,"version":"build-2065373602"},"reference-count":69,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This network meta-analysis was performed to rank the safety and efficacy of periprocedural anticoagulant strategies in patients undergoing atrial fibrillation ablation. MEDLINE, EMBASE, CENTRAL, and Web of Science were searched to identify randomized controlled trials comparing anticoagulant regimens in patients undergoing atrial fibrillation ablation up to July 1, 2021. The primary efficacy and safety outcomes were thromboembolic and major bleeding events, respectively, and the net clinical benefit was investigated as the primary-outcome composite. Seventeen studies were included (n = 6950). The mean age ranged from 59 to 70 years; 74% of patients were men and 55% had paroxysmal atrial fibrillation. Compared with the uninterrupted vitamin-K antagonist strategy, the odds ratios for the composite of primary safety and efficacy outcomes were 0.61 (95%CI: 0.31\u20131.17) with uninterrupted direct oral anticoagulants, 0.63 (95%CI: 0.26\u20131.54) with interrupted direct oral anticoagulants, and 8.02 (95%CI: 2.35\u201327.45) with interrupted vitamin-K antagonists. Uninterrupted dabigatran significantly reduced the risk of the composite of primary safety and efficacy outcomes (odds ratio, 0.21; 95%CI, 0.08\u20130.55). Uninterrupted direct oral anticoagulants are preferred alternatives to uninterrupted vitamin-K antagonists. Interrupted direct oral anticoagulants may be feasible as alternatives. Our results support the use of uninterrupted direct oral anticoagulants as the optimal periprocedural anticoagulant strategy for patients undergoing atrial fibrillation ablation.<\/jats:p>","DOI":"10.3390\/jcm11071872","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T21:44:52Z","timestamp":1648590292000},"page":"1872","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Optimal Anticoagulant Strategy for Periprocedural Management of Atrial Fibrillation Ablation: A Systematic Review and Network Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3700-4358","authenticated-orcid":false,"given":"Tabito","family":"Kino","sequence":"first","affiliation":[{"name":"Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minako","family":"Kagimoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanari","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama 234-0054, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunichi","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yokohama Rosai Hospital, Yokohama 222-0036, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideto","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gyotoku General Hospital, Ichikawa 272-0103, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiyuki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Ishigami","sequence":"additional","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","article-title":"Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association","volume":"139","author":"Benjamin","year":"2019","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1093\/europace\/eus153","article-title":"ESC-EURObservational Research Programme: The Atrial Fibrillation Ablation Pilot Study, conducted by the European Heart Rhythm Association","volume":"14","author":"Arbelo","year":"2012","journal-title":"Europace"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1161\/CIRCULATIONAHA.114.014092","article-title":"Randomized, Controlled Trial of the Safety and Effectiveness of a Contact Force-Sensing Irrigated Catheter for Ablation of Paroxysmal Atrial Fibrillation: Results of the TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) Study","volume":"132","author":"Reddy","year":"2015","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1093\/europace\/eur271","article-title":"Reduced fluoroscopy exposure during ablation of atrial fibrillation using a novel electroanatomical navigation system: A multicentre experience","volume":"14","author":"Stabile","year":"2012","journal-title":"Europace"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1093\/eurheartj\/ehv139","article-title":"A minimal or maximal ablation strategy to achieve pulmonary vein isolation for paroxysmal atrial fibrillation: A prospective multi-centre randomized controlled trial (the Minimax study)","volume":"36","author":"McLellan","year":"2015","journal-title":"Eur. 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