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\begin{document}

\title{Non-vitamin K Oral Anticoagulants in Hypertrophic Cardiomyopathy
Patients Undergoing Catheter Ablation of Atrial Fibrillation}



\author[1]{Antonio Creta}%
\author[2]{Ross Hunter}%
\author[3]{Mark Earley}%
\author[3]{Malcolm Finlay}%
\author[1]{Mehul Dhinoja}%
\author[4]{Simon Sporton}%
\author[1]{Anthony Chow}%
\author[1]{Saidi Mohiddin}%
\author[5]{Serge Boveda}%
\author[6,7]{Pedro Adragão}%
\author[5]{Zeynab Jebberi}%
\author[7]{Daniel Matos}%
\author[1]{Richard Schilling}%
\author[8]{Pier Lambiase}%
\author[3]{Rui Providência}%
\affil[1]{Barts and The London NHS Trust}%
\affil[2]{St Bartholomew's Hospital}%
\affil[3]{Barts Health NHS Trust}%
\affil[4]{Barts Heart Centre, St Bartholomew's Hospital}%
\affil[5]{Clinique Pasteur}%
\affil[6]{EP Centre Cardiology, Hospital de Santa Cruz}%
\affil[7]{Hospital de Santa Cruz}%
\affil[8]{Barts Heart Centre, Barts Health NHS trust }%


\vspace{-1em}



  
  \date{May 19, 2024}


\begingroup
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\selectlanguage{english}
\begin{abstract}
Introduction: Patients with hypertrophic cardiomyopathy (HCM) and atrial
fibrillation (AF) require chronic anticoagulation due to a high
thromboembolic risk. Evidence supporting use of non-vitamin K oral
anticoagulants (NOACs) in patients with HCM remains sparse, and there
are no data regarding the use of NOACs in HCM patients undergoing
catheter ablation of AF. Methods: Observational non-randomised study in
4 European Centres. We aimed to investigate the safety and efficacy of
NOACs compared with vitamin-K antagonists (VKAs) in patients with HCM
undergoing catheter ablation for AF. Results: One hundred thirty-seven
HCM patients (mean age 55.0\selectlanguage{ngerman}±13.4, 29.1\% female) underwent 230 catheter
ablations for AF (1.7±1.0 per patient). A total of 55 patients (39.4\%)
underwent 70 procedures (30.4\%) on NOAC, while the remaining were on
VKA. Warfarin (97.6\%) and rivaroxaban (56.4\%) were the most frequently
used agents in the respective groups. No procedure-related deaths were
reported. We observed no significant difference in the rate of
thromboembolism (VKA 0.6\%; NOAC 0\%; p=1.0) or minor bleeding (VKA
0.6\%; NOAC 1.4\%; p=0.54). There was a non-significant trend towards a
lower incidence of major bleeding (VKA 6.8\%; NOAC 1.4\%; p=0.09).
Conclusion: These preliminary data suggest that NOACs are at least as
safe and effective as VKAs in patients with HCM undergoing catheter
ablation for AF.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy




\section*{Introduction}

{\label{introduction}}

Hypertrophic cardiomyopathy (HCM) is the most frequent monogenic
cardiovascular disease and affects 1 out of every 500 individuals
{[}1{]}. Atrial fibrillation (AF) is a common feature of HCM, with an
estimated prevalence of 22.5\% {[}1{]}. Given the high thromboembolic
risk in HCM patients with concomitant AF, life-long oral anticoagulation
is recommended, regardless of the
CHA\textsubscript{2}DS\textsubscript{2}VASc score {[}2-3{]}.

Non-vitamin K anticoagulants (NOACs) have emerged as a valid and more
practical alternative to vitamin K antagonists (VKAs) {[}4{]}. Even
though data supporting the use of NOACs in patients with HCM and AF are
sparse, recent observational studies suggest that NOACs might be safely
used in this population {[}5{]}.

Catheter ablation is an established treatment for AF and is also used in
subjects with HCM {[}1{]}. Peri and post-operatively patients are
exposed to an increased risk of thromboembolism {[}6{]}. Complications
can occur in up to a fifth of HCM patients undergoing AF ablation
{[}7{]}. Although observational studies suggest that ablation can be
safely performed in HCM patients on VKA {[}1{]}, the safety and efficacy
of such a procedure while on NOACs has not yet been established. The aim
of this study was to address this knowledge gap.

\section*{Methods}

{\label{methods}}

\emph{Study design}

Observational study in four European centres. We included all patients
aged over 18 with confirmed diagnosis of HCM undergoing a catheter
ablation for AF. According to the guidelines of the European Society of
Cardiology {[}2{]}, HCM was defined as a wall thickness [?]15 mm in one or
more left ventricular myocardial segments (on either echocardiogram or
cardiac magnetic resonance imaging) that is not explained solely by
loading conditions. Participants needed to be on effective oral
anticoagulation (VKA, apixaban, edoxaban, rivaroxaban, or dabigatran)
for at least 30 days before the procedure to be considered for
inclusion. Patients on VKA had a target INR of 2-3. Peri-procedure
interruption or continuation of the oral anticoagulants, with or without
heparin bridging, was based on the local protocol of each centre at the
time of the ablation. In patients elected to VKA interruption with
heparin bridging, the VKA was substituted 3 days before the procedure
with enoxaparin 100 IU/kg twice a day or dalteparin 200 IU/kg daily. All
patients provided written informed consent prior to the procedure. The
study complied with the Declaration of Helsinki and the research
protocol was approved by the local ethics or audit committees.

\emph{Catheter ablation}

Procedures were performed under sedation or general anaesthesia,
according to each institution's protocol. Venous access was obtained via
the femoral vein, with use of vascular ultrasound at operator's
discretion. In the absence of patent foramen ovale, a single or dual
transseptal puncture was performed under fluoroscopic guidance.
Transesophageal echocardiography (TOE) was used based on operator
preference. Patients received intravenous heparin to maintain an
activated clotting time of 300--350 seconds. Pulmonary vein isolation
was the main procedural end-point, and was performed as a first step in
all procedures. Additional substrate modification was at operator's
discretion. Patients were evaluated before discharge, at 30-days, and
3-months after the procedure, additional visits and further testing were
allowed in case of symptoms.

\emph{Thromboembolic and bleeding events}

The following safety and efficacy endpoints were assessed {[}8{]}:

\begin{enumerate}
\tightlist
\item
  All-cause peri-procedural death.
\item
  Thromboembolism, which was defined as a composite of stroke, transient
  ischaemic attack (TIA), systemic or pulmonary embolism. A stroke was
  defined as a sudden focal neurological deficit of presumed
  cerebrovascular aetiology lasting for 24 hours, not due to another
  identifiable cause and confirmed by computed tomography or magnetic
  resonance imaging of the brain. If symptoms were short lasting
  (\textless{}24 h) and no evidence of necrosis was found on brain
  imaging, the event was considered to be a TIA. A systemic embolic
  event was defined as an abrupt vascular insufficiency associated with
  clinical or radiological evidence of arterial occlusion in the absence
  of another likely mechanism (e.g. atherosclerosis, instrumentation, or
  trauma). A pulmonary embolism was diagnosed when dyspnoea or other
  suggestive clinical presentation was accompanied by a confirmation of
  a new pulmonary perfusion or intra-luminal defect.
\item
  Major bleeding, which was defined as composite of cardiac tamponade,
  bleeding requiring intervention (e.g., either thrombin injection or
  surgery) or transfusion, massive haemoptysis, haemothorax,
  retroperitoneal bleeding, fatal bleed, or any other bleeding leading
  to prolongation of hospitalisation.
\item
  Minor bleeding, which was defined as a composite of puncture site
  bleeding, thigh ecchymosis or haematoma, pericardial effusion with no
  haemodynamic compromise, minor gastrointestinal bleeding, epistaxis,
  or any bleeding treated conservatively with no need for transfusion,
  surgery, or prolonged hospitalization.
\end{enumerate}

The criteria for definition of major or minor bleeding are strongly
based on the recommendation from the \emph{International Society on
Thrombosis and Haemostasis} {[}9{]}, but adapted for catheter ablation
of AF {[}8{]}.

\textbf{Statistical analysis}

The chi-square test and Student's t-test were used for comparison of
categorical and continuous variables, respectively. Levene's test was
used to check the homogeneity of variance; equivalent non-parametric
tests were used when Kolmogorov--Smirnov was in favour of the absence of
normal distribution. Results with \emph{P} \textless{} 0.05 were
regarded as significant. PASW Statistics version 18.0 was used for
descriptive and inferential statistical analysis.

\section*{Results}

{\label{results}}

One hundred thirty-seven patients (mean age 55.0\selectlanguage{ngerman}±13.4, 29.1\% female)
underwent 230 catheter ablations for AF (1.7±1.0 per patient). A total
of 55 patients (39.4\%) underwent 70 procedures (30.4\%) on NOAC, the
remaining were ablated while on VKAs. Warfarin (97.6\%) and rivaroxaban
(56.4\%) were the most frequently used agents in the respective groups.
VKA interruption regimen with low-molecular weight heparin bridging was
adopted in 56 catheter ablations (35\%). NOAC use was uninterrupted
pre-procedure in all patients but one (no heparin bridging was performed
either). Pre-procedural TOE was performed for 40 and 125 ablations in
the NOAC and VKA group (57.1\% vs. 78.1\%, respectively;
p\textless{}0.001); 3 procedures in the VKA group were deferred due to
the presence of intracardiac thrombus (p=0.55), despite at least two INR
measurements \textgreater{}2 in the 4 weeks pre ablation. Most patients
had paroxysmal AF (57.5\%) at baseline, and mean AF duration was 3.3±3.1
years. Mean CHA\textsubscript{2}DS\textsubscript{2}VASc and HAS-BLED
score were 1.5±1.5 and 0.8±0.9, respectively. As many as 10.4\% had a
history of stroke or TIA, and 3.6\% was on concomitant single
antiplatelet therapy. Mean left atrial diameter was 47±7mm.

Some differences were found at baseline population between the two
groups: left ventricular ejection fraction, wall thickness and outflow
tract gradient were higher in subjects on NOAC; patients on VKA more
frequently presented with persistent AF or had history of previous
surgical myectomy. Detailed baseline characteristics are reported in
Table 1.

\textbf{Procedural outcomes}

The overall rate of complication was 9.3\%. No procedure-related deaths
were reported. A low incidence of thromboembolism (0.7\%) was observed,
with only one patient on interrupted VKA (with heparin bridging)
suffering from an ischemic stroke immediately after the ablation with
minor neurological sequalae. No thromboembolic events were reported in
the NOAC group.

There was a numerically higher rate of major bleeding with VKA versus
NOAC (6.8\% vs. 1.4\%, respectively; p=0.09); after excluding patients
on interrupted VKA with heparin bridging the numerical difference was
confirmed (5.8\% vs. 1.4\%, p=0.16). The overall rate of pericardial
effusion requiring pericardiocentesis was 4.0\%, and was numerically
higher in the VKA versus NOAC group (4.5\% vs 1.4\%, respectively;
p=0.11). Puncture complications fulfilling major bleeding criteria were
observed in 3 patients (1.3\%) on VKA. The incidence of minor bleeding
was low (0.9\%) and comparable between the two groups. These results are
shown in Table 3 and S-Table 4.

\textbf{Discussion}

Preliminary data from this multicentre study suggest that use of NOACs
appears to be effective and safe in HCM patient undergoing catheter
ablation of AF. The incidence of thromboembolic events was low with both
VKA and NOAC. A non-significant but numerically higher rate of major
bleeding and cardiac tamponade in patients on VKA versus NOAC was
observed.

Several landmark trials have demonstrated that NOACs are at least as
effective as VKA for prevention of thromboembolic events of AF
{[}10-13{]}. However, no randomised data are available on the
effectiveness of NOAC in the HCM population. Similar to our findings,
four observational studies have suggested that NOACs, compared to VKA,
are associated with a similar or lower rate of thromboembolic and
bleeding events in subjects with HCM and AF {[}14-17{]}. Current HCM
guidelines from the European Society of Cardiology suggest the use of
NOACs as a second-line drugs in patient with concomitant AF {[}2{]}.
According to the \emph{European Heart Rhythm Association 2018 Practical
Guide on Oral Anticoagulants} , HCM patients might be eligible for NOACs
{[}4{]}. The 2014 American Heart Association/American College of
Cardiology/Heart Rhythm Society guidelines for AF (confirmed in 2019)
state that NOAC ``might represent another option to reduce the risk of
thromboembolic events, but data for patients with HCM are not
available'' {[}3, 18{]}.

Catheter ablation represents an effective treatment for symptomatic
drug-refractory AF {[}19-20{]}. However, the intra- and post-procedural
thromboembolic risk is not negligible and requires effective
anticoagulation. In fact, both manipulation of the catheters and
creation of lesions inside the left atrium can lead to local thrombus
formation {[}6{]}. There is a significant body of evidence showing that
NOACs can be safely used in patients undergoing catheter ablation of AF,
with a similar or lower rate of bleeding and thromboembolic
complications compared to VKA {[}6, 21{]}. The RE-CIRCUIT {[}22{]},
VENTURE-AF {[}23{]} and AXAFA {[}24{]} trials have respectively
demonstrated the safety and efficacy of uninterrupted dabigatran,
rivaroxaban, and apixaban during catheter ablation of AF. However,
patients with HCM were not represented in these trials. Data on catheter
ablation of AF in HCM patients are still sparse, and only arising from
small observational studies {[}1{]}. A systematic review and metanalysis
from our group has shown that catheter ablation of AF appears to be safe
in the HCM population, and might represent a valuable option despite a
higher arrhythmia relapse rate compared to the general population
{[}1{]}.

To the best of our knowledge, we present the largest published series of
HCM patients undergoing catheter ablation of AF, and this is the first
study to investigate the effectiveness of NOACs in this high-risk
setting. We are not aware of other studies where NOACs have been used at
the time of AF ablation in individuals with HCM.

Our findings are reassuring and add to the body of evidence suggesting
that use of NOACs appears to be safe and effective in HCM patients with
AF, with a risk profile which appears at least similar to VKAs. Of note,
no intracardiac thrombus was identified in the 40 pre-procedural TOEs in
the NOAC group. Similarly, there were no embolic events in the NOAC
group and major bleeding and cardiac tamponade were numerically lower
compared to VKA. We believe our findings might have relevant clinical
implications in HCM patients with AF elected for an ablative strategy as
they ease some of the concerns regarding NOACs and the absence of data
in this high-risk setting.

\textbf{Limitations}

Several limitations should be acknowledged. This was an observational
and non-randomised study, however it is unlikely that a randomised trial
will ever be performed of NOAC versus VKA in HCM patients undergoing AF
ablation. Whilst our data are non-randomised it is hoped that they will
be a useful point of reference for others considering this approach.
Given the small sample size, this study was underpowered to demonstrate
non-inferiority of NOAC vs. VKA for most of the study comparisons (which
referred to events with a rate \textless{}10\%). However, our
multicentre data constitute the largest cohort of HCM patients
undergoing AF ablation, and this is the first study to investigate the
use of NOAC in this setting. An interrupted oral anticoagulation
strategy with heparin bridging is no longer the standard of care and was
used in a few patients in this series. However, the observed numerical
differences were maintained even in sub-analyses excluding such
patients. We could not provide data on silent cerebral infarction, as
patients did not routinely undergo brain magnetic resonance imaging
post-ablation. Only a limited number of patients were on edoxaban or
dabigatran.

\textbf{Conclusion}

These preliminary data suggest that NOACs are as safe and effective
compared to VKA in patients with HCM undergoing catheter ablation for
AF.

\textbf{Disclosures and Conflicts of Interest} -- AC has received
educational grants from Boston Scientific and Abbott; RJS has had
research agreements and speaker fees from Abbott, Medtronic, Boston
Scientific, and Biosense Webster; PDL has received educational grants
from Medtronic and Boston Scientific \& is supported by UCL/UCLH
Biomedicine NIHR and Barts BRC; MF has received speaker fees from
Biotronik and Medtronic, and owns stocks of Epicardio ltd. All other
authors have reported that they have no relationships relevant to the
contents of this paper to disclose.

\textbf{Tables}

\textbf{Table 1.} Baseline characteristics of the study population

\textbf{Table 2.} Type of oral anticoagulant

\textbf{Table 3.} Efficacy and Safety Endpoints

\textbf{Supplementary materials}

\textbf{Supplementary Table 4} . Subgroup analysis

\textbf{References}

{[}1{]} Providencia R, Elliott P, Patel K, McCready J, Babu G,
Srinivasan N, Bronis K, Papageorgiou N, Chow A, Rowland E, Lowe M, Segal
OR, Lambiase PD. Catheter ablation for atrial fibrillation in
hypertrophic cardiomyopathy: a systematic review and
meta-analysis.\emph{Heart} 2016;102:1533--1543

{[}2{]} Elliott P,~ Anastasakis A,~Borger MA,~Borggrefe M,~Cecchi
F,~Charron P,~Hagege AA,~Lafont A,~Limongelli G,~Mahrholdt H,~McKenna
WJ,~Mogensen J,~Nihoyannopoulos P,~Nistri S,~Pieper PG,~Pieske
B,~Rapezzi C,~Rutten FH,~Tillmanns C,~Watkins H. 2014 ESC Guidelines on
diagnosis and management of hypertrophic cardiomyopathy: the Task Force
for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the
European Society of Cardiology (ESC). \emph{Eur Heart J}
.~2014;14;35:2733-2779

{[}3{]} January CT,~Wann LS,~Alpert JS,~Calkins H,~Cigarroa
JE,~Cleveland JC Jr,~Conti JB,~Ellinor PT,~Ezekowitz MD,~Field
ME,~Murray KT,~Sacco RL,~Stevenson WG,~Tchou PJ,~Tracy CM,~Yancy
CW;~ACC/AHA Task Force Members. 2014 AHA/ACC/HRS Guideline
for~the~Management of Patients With~Atrial Fibrillation. \emph{J Am Coll
Cardiol} .\textbf{~} 2014;64;e1-e76.

{[}4{]} Steffel J,~Verhamme P,~Potpara TS,~Albaladejo P,~Antz
M,~Desteghe L,~Haeusler KG,~Oldgren J,~Reinecke H,~Roldan-Schilling
V,~Rowell N,~Sinnaeve P,~Collins R,~Camm AJ,~Heidbüchel H;~ESC
Scientific Document Group. The 2018 European Heart Rhythm Association
Practical Guide on the use of non-vitamin K antagonist oral
anticoagulants in patients with atrial fibrillation. \emph{Eur Heart J}
.~2018;39:1330-1393

{[}5{]} Zhou Y,~He W,~Zhou Y,~Zhu W. Non-vitamin K antagonist oral
anticoagulants in patients with hypertrophic cardiomyopathy and atrial
fibrillation: a systematic review and meta-analysis. \emph{J Thromb
Thrombolysis} .~2019. doi: 10.1007/s11239-019-02008-3. {[}Epub ahead of
print{]}

{[}6{]} Calkins H,~Hindricks G,~Cappato R,~Kim YH,~Saad EB,~Aguinaga
L,~Akar JG,~Badhwar V,~Brugada J,~Camm J,~Chen PS,~Chen SA,~Chung
MK,~Nielsen JC,~Curtis AB,~Davies DW,~Day JD,~d'Avila A,~de Groot
NMSN,~Di Biase L,~Duytschaever M,~Edgerton JR,~Ellenbogen KA,~Ellinor
PT,~Ernst S,~Fenelon G,~Gerstenfeld EP,~Haines DE,~Haissaguerre M,~Helm
RH,~Hylek E,~Jackman WM,~Jalife J,~Kalman JM,~Kautzner J,~Kottkamp
H,~Kuck KH,~Kumagai K,~Lee R,~Lewalter T,~Lindsay BD,~Macle L,~Mansour
M,~Marchlinski FE,~Michaud GF,~Nakagawa H,~Natale A,~Nattel S,~Okumura
K,~Packer D,~Pokushalov E,~Reynolds MR,~Sanders P,~Scanavacca
M,~Schilling R,~Tondo C,~Tsao HM,~Verma A,~Wilber DJ,~Yamane T. 2017
HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and
Surgical Ablation of Atrial Fibrillation. \emph{Heart Rhythm}
~2017;14:e275-e44

{[}7{]} Garg L, Sabzwari SRA, Akbar G, Ayele H, Agrawal S, Agarwal M,
Gordon J, Dusaj R, Nazir T, Bozorgnia~B, Martinez M. Outcomes of cateter
ablation for atrial fibrillation in patients with hypertrophic
cardiomyopathy. \emph{J Am Coll Cardiol} . 2019;73;suppl 1;478 (abstract
presented at the American Journal of Cardiology Congress 2019- 68th
Annual Scientific Sessions)

{[}8{]} Providência R,~Marijon E,~Albenque JP,~Combes S,~Combes
N,~Jourda F,~Hireche H,~Morais J,~Boveda S. Rivaroxaban and dabigatran
in patients undergoing catheter ablation of atrial
fibrillation.\emph{Europace} .~2014;16:1137-1144

{[}9{]} Schulman S,~Kearon C;~Subcommittee on Control of Anticoagulation
of the Scientific and Standardization Committee of the International
Society on Thrombosis and Haemostasis. Definition of major bleeding in
clinical investigations of antihemostatic medicinal products in
non-surgical patients. \emph{J Thromb Haemost} .~2005;3:692-694

{[}10{]} Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD,
Halperin JL, Waldo AL, Ezekowitz MD, Weitz JI, S\selectlanguage{english}pinar J, Ruzyllo W, Ruda
M, Koretsune Y, Betcher J, Shi M, Grip LT, Patel SP, Patel I, Hanyok JJ,
Mercuri M, Antman EM. Edoxaban versus warfarin in patients with atrial
fibrillation. \emph{N Engl J Med} .~2013;369:2093-2104

{[}11{]} Granger CB, Alexander JH, McMurray JJV, Lopes RD, Hylek EM,
Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R,
Easton JD, Ezekowitz JA, Flaker G, Gar- cia D, Geraldes M, Gersh BJ,
Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P,
Jansky P, Lewis BS, Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt
FWA, Zhu J, Wallentin L. Apixaban versus warfarin in patients with
atrial fibrillation. \emph{New Engl J Med} . 2011;365:981--992

{[}12{]} Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W,
Breithardt G, Halperin JL, Hankey GJ, Piccini JP, Becker RC, Nessel CC,
Paolini JF, Berkowitz SD, Fox KAA, Califf RM. Rivaroxaban versus
warfarin in nonvalvular atrial fibrillation. \emph{New Engl J
Med.}2011;365:883--891

{[}13{]} Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J,
Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M,
Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener H, Joyner CD,
Wallentin L. Dabigatran versus warfarin in patients with atrial
fibrillation. \emph{New Engl J Med.} 2009;361:1139--1151

{[}14{]} Jung H, Yang P, Jang E, Yu HT, Kim T, Uhm J, Kim J, Pak H, Lee
M, Joung B, Lip GYH. Effectiveness and safety of non-vitamin K
antagonist oral anticoagulants in patients with atrial fibrillation with
hypertrophic cardiomyopathy. \emph{Chest} . 2019;155:354--363

{[}15{]} Dominguez F, Climent V, Zorio E, Ripoll-Vera T, Salazar-Men-
diguchi\selectlanguage{english}a J, Garci\selectlanguage{english}a-Pinilla JM, Urbano-Moral JA, Ferna\selectlanguage{english}ndez- Ferna\selectlanguage{english}ndez X,
Lopez-Cuenca D, Ajo-Ferrer R, Sanz-Sanchez J, Gomez-Perez Y,
Lo\selectlanguage{english}pez-Garrido MA, Barriales-Villa R, Gimeno JR, Garcia-Pavia P. Direct
oral anticoagulants in patients with hypertrophic cardiomyopathy and
atrial fibrillation. \emph{Int J Cardiol} . 2017;248:232--238

{[}16{]} Noseworthy PA, Yao X, Shah ND, Gersh BJ (2016) Stroke and
bleeding risks in NOAC- and warfarin-treated patients with hyper-
trophic cardiomyopathy and atrial fibrillation. \emph{J Am Coll Cardiol}
. 2016;67:3020--3021

{[}17{]} Lee H, Kim H, Jung J, Han K, Lee H, Park J, Kim HM, Kim Y,
Ommen SR. Novel oral anticoagulants for primary stroke prevention in
hypertrophic cardiomyopathy patients with atrial
fibrillation.\emph{Stroke} . 2019;50:2582--2586

{[}18{]} January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland
JC Jr, Ellinor PT, Ezekowitz MD, Field ME, Furie KL, Heidenreich PA,
Murray KT, Shea JB, Tracy CM, Yancy CW. 2019 AHA/ACC/HRS focused update
of the 2014 AHA/ACC/HRS guideline for the management of patients with
atrial fibrillation: a report of the American College of Cardiology
Foundation/American Heart Association Task Force on Clinical Practice
Guidelines and the Heart Rhythm Society. \emph{J Am Coll Cardiol} .
2019;74:104--132

{[}19{]} Creta A, Provid\selectlanguage{ngerman}ência R, Adragao P, de Asmundis C, Chun J,
Chierchia G, Defaye P, Schmidt B, Anselme F, Finlay M, Hunter RJ,
Papageorgiou N, Lambiase PD, Schilling RJ, Combes S, Combes N, Albenque
JP, Pozzilli P, Boveda S. Impact of Type-2 Diabetes Mellitus on the
Outcomes of Catheter Ablation of Atrial Fibrillation (European
observational multicentre study). \emph{Am J of Cardiol.}2020;15:901-906

{[}20{]} Providência R,~de Asmundis C,~Chun J,~Chierchia G,~Defaye
P,~Anselme F,~Creta A,~Lambiase PD,~Schmidt B,~Chen S,~Hunter RJ,~Combes
S,~Honarbakhsh S,~Combes N,~Sousa MJ,~Jebberi Z,~Albenque JP,~Boveda S.
Catheter ablation of atrial fibrillation in patients with heart failure
with reduced ejection fraction: Real world experience from six European
centers.\emph{J Cardiovasc Electrophysiol}.~2019;30:1270-1277

{[}21{]} Sawhney V,~Shaukat M,~Volkova E,~Jones N,~Providencia
R,~Honarbakhsh S,~Dhillon G,~Chow A,~Lowe M,~Lambiase PD,~Dhinoja
M,~Sporton S,~Earley MJ,~Schilling RJ,~Hunter RJ. Catheter ablation for
atrial fibrillation on uninterrupted direct oral anticoagulants: A safe
approach.\emph{Pacing Clin Electrophysiol}.~2018;41;1001-1009

{[}22{]} Calkins H,~Willems S,~Gerstenfeld EP,~Verma A,~Schilling
R,~Hohnloser SH,~Okumura K,~Serota H,~Nordaby M,~Guiver K,~Biss
B,~Brouwer MA,~Grimaldi M;~RE-CIRCUIT Investigators. Uninterrupted
Dabigatran versus Warfarin for Ablation in Atrial Fibrillation. \emph{N
Engl J Med} .~2017;376:1627-1636

{[}23{]} Cappato R,~Marchlinski FE,~Hohnloser SH,~Naccarelli GV,~Xiang
J,~Wilber DJ,~Ma CS,~Hess S,~Wells DS,~Juang G,~Vijgen J,~Hügl
BJ,~Balasubramaniam R,~De Chillou C,~Davies DW,~Fields LE,~Natale
A;~VENTURE-AF Investigators. Uninterrupted rivaroxaban vs. uninterrupted
vitamin K antagonists for catheter ablation in non-valvular atrial
fibrillation.

\emph{Eur Heart J}.~2015;36:1805-1811

{[}24{]} Kirchhof P,~Haeusler KG,~Blank B,~De Bono J,~Callans D,~Elvan
A,~Fetsch T,~Van Gelder IC,~Gentlesk P,~Grimaldi M,~Hansen J,~Hindricks
G,~Al-Khalidi HR,~Massaro T,~Mont L,~Nielsen JC,~Nölker G,~Piccini
JP,~De Potter T,~Scherr D,~Schotten U,~Themistoclakis S,~Todd D,~Vijgen
J,~Di Biase L. Apixaban in patients at risk of stroke undergoing atrial
fibrillation ablation. \emph{Eur Heart J} .~2018;39:2942-2955

\textbf{Table 1} . Demographics\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{Global Sample} \textbf{n=137} \textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{VKA} \textbf{n=82} \textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{NOAC} \textbf{n=55*} \textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{P}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Age}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
55.0\selectlanguage{ngerman}±13.4\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
53.3\selectlanguage{ngerman}±13.3\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
57.2\selectlanguage{ngerman}±13.2\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.27\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Female Sex}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
29.1\% (39)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
25.6\% (21)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
32.7\% (18)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.36\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{AF type at index procedure}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.013\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Paroxysmal}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
57.5\% (77)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
40.2\% (33)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
61.8\% (34)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Persistent}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
41.0\% (55)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
59.8\% (49)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
38.2\% (21)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Longstanding Persistent}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.5\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
2.4\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Baseline ECG in Sinus Rhythm -- Index Procedure}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
58.2\% (78)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
51.2\% (42)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
65.4\% (36)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.1\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Previous Non-AF ablation}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9.8\% (13)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9.8\% (8)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9.0\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.71\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Previous Alcohol Septal Ablation}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.5\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
2.4\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
7.3\% (4)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.17\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Previous Surgical Myectomy}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.4\% (14)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
15.8\% (13)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.8\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.008\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{LV Apical Aneurysm}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.5\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
2.4\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.51\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Congestive HF}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
15.7\% (21)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
15.8\% (13)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.5\% (8)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.83\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Hypertension}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
25.4\% (34)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
19.5\% (16)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
32.7\% (18)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.79\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Diabetes}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.2\% (19)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.6\% (12)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12.7\% (7)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.54\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Stroke or TIA}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.4\% (14)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12.2\% (10)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
7.3\% (4)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.35\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Vascular Disease}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9.7\% (13)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
8.5\% (7)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.9\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.64\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Chronic Kidney Disease}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.8\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.6\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
5.4\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.61\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Obstructive Sleep Apnoea}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
6.7\% (9)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
11\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
5.4\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.67\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{NYHA Class}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.8\selectlanguage{ngerman}±0.7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.8\selectlanguage{ngerman}±0.7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.7\selectlanguage{ngerman}±0.7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.91\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{CHA\textsubscript{2}DS\textsubscript{2}VASc}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.5\selectlanguage{ngerman}±1.5\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.3\selectlanguage{ngerman}±1.4\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.6\selectlanguage{ngerman}±1.6\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.21\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{HAS-BLED}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.8\selectlanguage{ngerman}±0.9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.8\selectlanguage{ngerman}±0.9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.8\selectlanguage{ngerman}±0.9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.39\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Single antiplatelet therapy}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.6\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
6.1\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.08\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Dual antiplatelet therapy}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Apical Hypertrophy}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.9\% (14)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
7.3\% (8)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.9\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.79\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Moderate to Severe MR}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12.2\% (14)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
7.3\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.5\% (8)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.17\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Restrictive pattern}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
21.6\% (29)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
23.2\% (19)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
18.2\% (10)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.48\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Max LVOT gradient (mm Hg)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14\selectlanguage{ngerman}±24\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9\selectlanguage{ngerman}±13\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
21\selectlanguage{ngerman}±32\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.02\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Max LV Thickness (mm)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
17\selectlanguage{ngerman}±4\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
17\selectlanguage{ngerman}±4\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
18\selectlanguage{ngerman}±3\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.009\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{LA diameter (mm)}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
47\selectlanguage{ngerman}±7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
49\selectlanguage{ngerman}±7\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
45\selectlanguage{ngerman}±6\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.5\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{LVEF}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
58\selectlanguage{ngerman}±9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
57\selectlanguage{ngerman}±10\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
59\selectlanguage{ngerman}±9\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.017\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Abbreviations. VKA: vitamin-K antagonist. NOAC: non-vitamin K
anticoagulant. AF: atrial fibrillation. LV: left ventricle. HF: heart
failure. MR: mitral regurgitation. LVOT: left ventricular outflow tract.
LA: left atrium. LVEF: left ventricular ejection fraction.

\textbf{Table 2.} Type of oral anticoagulant\selectlanguage{english}
\begin{longtable}[]{@{}lll@{}}
\toprule
& \textbf{VKA} \textbf{n=82} \textbf{\% (n)} & \textbf{NOAC}
\textbf{n=55} \textbf{\% (n)}\tabularnewline
\midrule
\endhead
\textbf{Warfarin} & 97.6\% (80) & -\tabularnewline
\textbf{Flunidione} & 2.4\% (2) & -\tabularnewline
\textbf{Apixaban} & - & 32.7\% (18)\tabularnewline
\textbf{Dabigatran} & - & 7.3\% (4)\tabularnewline
\textbf{Edoxaban} & - & 3.6\% (2)\tabularnewline
\textbf{Rivaroxaban} & - & 56.4\% (31)\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 3} . Outcomes\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{Global Sample} \textbf{n=230 procedures} \textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{VKA} \textbf{n=160 procedures} \textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{NOAC} \textbf{n=70} \textbf{procedures} \textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{P}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Thromboembolism}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
TIA\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pulmonary embolism\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Systemic embolism\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Major bleeding}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
5.2\% (12)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
6.9\% (11)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.09\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Cardiac tamponade\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.9\% (9)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.8\% (7)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.26\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Vascular-access related\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.3\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.8\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.55\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Minor bleeding}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.9\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.54\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Haematoma\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pericardial effusion not requiring drain\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.30\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Other complications}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.5\% (8)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.1\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.3\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.65\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pneumonia\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
PV stenosis\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Acute pulmonary oedema\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.3\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.2\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.91\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Complete AV block\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.30\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Phrenic nerve palsy\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.9\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.54\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Abbreviations. VKA: vitamin-K antagonist. NOAC: non-vitamin K
anticoagulant. PV: pulmonary vein. AV: atrio-ventricular.

\textbf{Supplementary Table 4} . Sub-analysis of outcomes in patients on
uninterrupted oral anticoagulant regimen\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{Uninterrupted oral anticoagulant} \textbf{n=172 procedures}
\textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{Uninterrupted} \textbf{VKA} \textbf{n=104 procedures} \textbf{\%
(n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{Uninterrupted} \textbf{NOAC} \textbf{n=69} \textbf{procedures}
\textbf{\% (n)}\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\textbf{P}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Thromboembolism}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
TIA\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pulmonary embolism\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Systemic embolism\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Major bleeding}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4\% (7)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
5.8\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.16\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Cardiac tamponade\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
3.5\% (6)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.8\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.24\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Vascular-access related\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Minor bleeding}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.2\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.77\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Haematoma\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pericardial effusion not requiring drain\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.40\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{Other complications}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.6\% (8)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.8\% (5)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
4.3\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.88\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Pneumonia\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
PV stenosis\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Acute pulmonary oedema\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.7\% (3)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.9\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.81\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Complete AV block\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.6\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0\%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.40\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Phrenic nerve palsy\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.2\% (2)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.0\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.4\% (1)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.77\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Abbreviations. VKA: vitamin-K antagonist. NOAC: non-vitamin K
anticoagulant. PV: pulmonary vein. AV: atrio-ventricular.

\selectlanguage{english}
\FloatBarrier
\end{document}

