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ODIn-AF试验的原理与设计:房颤肺静脉隔离术后使用达比加群口服抗凝预防无症状性脑栓塞的随机评估

Rationale and design of the ODIn-AF Trial: randomized evaluation of the prevention of silent cerebral thromboembolism by oral anticoagulation with dabigatran after pulmonary vein isolation for atrial fibrillation.

作者信息

Schrickel Jan W, Linhart Markus, Bänsch Dietmar, Thomas Daniel, Nickenig Georg

机构信息

Department of Medicine-Cardiology, University Hospital Bonn, Bonn, Germany.

Department of Cardiology, Rhythmology, University Hospital Rostock, Rostock, Germany.

出版信息

Clin Res Cardiol. 2016 Feb;105(2):95-105. doi: 10.1007/s00392-015-0933-1. Epub 2015 Oct 29.

Abstract

Oral anticoagulation treatment following clinically successful catheter ablation of atrial fibrillation is controversial. Recent guidelines recommend continuation of oral anticoagulation in all patients with CHA2DS2VASc score ≥ 2 even if there is no evidence of recurrent atrial fibrillation. Due to lack of prospective data, the net clinical benefit of oral anticoagulation after successful ablation in these patients is unclear. As oral anticoagulation bears the risk of severe bleeding events, the ODIn-AF study aims to evaluate the effect of oral anticoagulation on the incidence of silent cerebral embolic events in patients with a high risk for embolic events, but free from symptomatic atrial fibrillation after successful pulmonary vein ablation.

摘要

房颤导管消融临床成功后口服抗凝治疗存在争议。近期指南建议,所有CHA2DS2VASc评分≥2的患者即使没有房颤复发证据也应继续口服抗凝治疗。由于缺乏前瞻性数据,这些患者消融成功后口服抗凝治疗的净临床获益尚不清楚。鉴于口服抗凝治疗存在严重出血事件风险,ODIn-AF研究旨在评估口服抗凝治疗对肺静脉消融成功后有栓塞事件高风险但无症状性房颤患者无症状脑栓塞事件发生率的影响。

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