DENVER — Anticoagulation around arrhythmia-related procedures will be in the spotlight at this year’s Heart Rhythm Society meeting.
Two late-breaking clinical trials slated for presentation here Thursday tackle the issue. COMPARE looks at whether continuation of warfarin (Coumadin) or bridging with heparin is best during atrial fibrillation ablation. BRUISE CONTROL looks at the same question during implantation of a defibrillator or pacemaker.
Both could have a significant impact on clinical practice, Anne M. Gillis, MD, president of the society and medical director of the cardiac arrhythmia program at the University of Calgary, Alberta, predicted in an interview with MedPage Today.
“Traditionally in many centers, if patients were on warfarin, the oral anticoagulant, and were going to have a procedure, the drug would be stopped and higher-risk patients might be admitted for bridging with intravenous heparin or treated with injections of low-molecular-weight heparin,” she explained. “There have been concerns that that approach might increase the risk of complications.”
Bruce Wilkoff, MD, director of cardiac pacing and tachyarrhythmia devices at the Cleveland Clinic and immediate past president of the HRS, agreed and pointed to the large number of patients potentially affected.
One-third of device patients have atrial fibrillation and so are on warfarin or another anticoagulant, he noted in an interview with MedPage Today.
Other highlights from the same late-breaking session will be:
- Long-term durability results on a newer generation of copolymer-coated device leads from a large registry study
- Long-term mortality results from the PROTECT AF trial comparing left atrial appendage closure with the Watchman device to medical treatment with warfarin alone in atrial fibrillation
- Results from the PRECISE trial looking at ablation targeting precise sites of aberrant electrical signals outside the pulmonary vein in paroxysmal atrial fibrillation
An expert consensus statement on management and diagnosis of inherited arrhythmias coming out Friday at the conference should prove useful as well, noted Arthur J. Moss, MD, a cardiologist at the University of Rochester Medical Center in Rochester, N.Y.
He also called attention to registry results on a wearable defibrillator, to be presented at a late-breaking session Friday.
Another highly anticipated session is the opening plenary by former U.S. president Bill Clinton. While Wilkoff noted that the topic remains a bit of a secret, Gillis pointed to the Clinton Foundation’s initiatives to improve access to and quality of healthcare globally.
The Heart Rhythm Society meeting has been growing in international scope to the point where 40% of attendees and 50% of the scientific abstracts come from outside the U.S., Giles noted.
However, the media has been prohibited from attending the talk at Clinton’s request. Gillis apologized on behalf of her society but said it was part of the contractual agreement to bring him in to what is anticipated to be a packed session. Clinton did not respond to a request for comment.
Source: MedPage Today.
