Antikoagulation bei linksatrialer Katheterablation

Left atrial catheter ablation is an established treatment for rhythm maintenance in patients with atrial fibrillation and other supraventricular arrhythmias. There is growing evidence that rhythm-preserving therapy, in addition to improving quality of life and relieving atrial fibrillation-related symptoms, may prevent cardiovascular events such as ischemic stroke and help to preserve cognitive function. However, clinically silent acute cerebral ischemia is found in about a quarter of patients after left atrial fibrillation ablation by MRI and an estimated 0.2-0.3 % of all ablated patients experience cerebral ischemia with manifest neurological deficits peri-intervention. Optimal anticoagulation to prevent thromboembolic events during left atrial catheter ablation is therefore a central element in a holistic therapy concept. In this article, the current evidence and the results of the AFNET-coordinated AXAFA-AFNET 5 study will be discussed.