{"doi":"10.1093/europace/euaa199","title":"Periprocedural anticoagulation in the uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation (ELIMINATE-AF) trial","abstract":"AIMS: This post hoc analysis of ELIMINATE-AF evaluated requirements of unfractionated heparin (UFH) and procedure-related bleeding in atrial fibrillation (AF) patients undergoing ablation with uninterrupted edoxaban or vitamin K antagonist (VKA) therapy. METHODS AND RESULTS: Patients were randomized 2:1 to once-daily edoxaban 60 mg (or dose-reduced 30 mg) or dose-adjusted VKA (target international normalized ratio: 2.0-3.0). Uninterrupted anticoagulation was mandated for 21-28 days' pre-ablation and 90 days' post-ablation. During ablation, UFH administration targeted an activated clotting time (ACT) of 300-400 s. Periprocedural bleeding was differentiated between procedure-related (bleeding at puncture side, cardiac tamponade) and unrelated events. Of 614 randomized patients, 553 received study drug and underwent catheter ablation (edoxaban n = 375; VKA n = 178). The median (Q1-Q3) time from last dose to ablation procedure was 14.8 (13.3-16.5) vs. 16.5 (14.8-19.5) h (edoxaban vs. VKA group, respectively). Mean ACT (SD) ≥300 s was observed in 52% edoxaban- vs. 76% VKA-treated patients, despite a higher mean (SD) UFH dose in the edoxaban vs. VKA group [14 261 (6397) IU vs. 11 473 (4300) IU; exploratory P-value < 0.0001]. In the edoxaban group, 13 patients (3.5%) had procedure-related bleeds of whom 9 had received an UFH dose above the median (13 000 IU). In the VKA arm, 7 patients (3.9%) had procedure-related bleeds of whom 3 had received an UFH dose above the median (10 225 IU). CONCLUSION: The rate of procedure-related major/clinically relevant non-major bleeding did not differ between the treatment arms despite higher doses of UFH used with edoxaban vs. VKA to achieve a target ACT during AF ablation.","journal":"EP Europace","year":2020,"id":85303,"datarank":0.35907518431061214,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.04715895305863674,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.04715895305863674,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":6,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9526,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02942576"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":29232,"name":"A. John Camm","orcid":"0000-0002-2536-2871","position":1,"is_corresponding":false},{"id":436322,"name":"Riccardo Cappato","orcid":"0000-0003-0615-9525","position":2,"is_corresponding":false},{"id":253776,"name":"Hans‐Christoph Diener","orcid":"0000-0002-6556-8612","position":3,"is_corresponding":false},{"id":58234,"name":"Hein Heidbüchel","orcid":"0000-0001-9301-8127","position":4,"is_corresponding":false},{"id":70536,"name":"Lluı́s Mont","orcid":"0000-0002-8115-5906","position":5,"is_corresponding":false},{"id":89289,"name":"Carlos A. Morillo","orcid":"0000-0002-8739-2099","position":6,"is_corresponding":false},{"id":437079,"name":"Hans‐Joachim Lanz","orcid":null,"position":7,"is_corresponding":false},{"id":437080,"name":"Heiko Rauer","orcid":null,"position":8,"is_corresponding":false},{"id":436323,"name":"Paul‐Egbert Reimitz","orcid":"0000-0002-6248-4691","position":9,"is_corresponding":false},{"id":437081,"name":"Rüdiger Smolnik","orcid":null,"position":10,"is_corresponding":false},{"id":340036,"name":"Josef Kautzner","orcid":"0000-0002-1632-6182","position":11,"is_corresponding":false},{"id":55163,"name":"Stefan H. Hohnloser","orcid":"0000-0001-5030-3315","position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":null,"created_at":"2026-07-18T21:56:02.794896Z","pmid":"33249467","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}