Non-vitamin K oral anticoagulants in patients with atrial fibrillation after cardiac surgery: the results of the European Heart Rhythm Association Survey

Abstract

The purpose of this European Heart Rhythm Association survey was to assess the current practice concerning the use of oral anticoagulation in patients with post-operative atrial fibrillation (pre-existing or new-onset). The survey highlights the considerable heterogeneity of the type of anticoagulation, with 25% of the centres never using the non-vitamin K antagonist oral anticoagulants (NOACs) in this setting, as well the timing of oral anticoagulation initiation, the use and dosing of low-molecular-weight heparins, and the duration of anticoagulation when sinus rhythm is restored. One-third of the centres stated that they perceived that the risk of major pericardial bleeding requiring pericardiocentesis was higher when NOACs were used compared with vitamin K antagonists. Overall, the responding centres estimated the incidence of major pericardial haemorrhage to be 2.4%. More data are needed to inform practice guidelines in this field.