Abstract: Objective To compare the efficacy and safety of bridging therapy with fondaparinux versus low-molecular-weight
heparin (LMWH) in patients undergoing radiofrequency ablation for atrial fibrillation (AF). Methods AF patients undergoing
radiofrequency ablation between January, 2009 and June, 2013 in Nanfang Hospital were analyzed. The patients received
subcutaneous injection of either fondaparinux or LMWH as a bridging therapy during warfarin discontinuation 5 days before
the ablation until a post-ablation international normalized ratio (INR) of 2.0-3.0 was achieved. Anticoagulant-related
complications, identified and classified as thromboembolic and bleeding events, were compared between the two groups.
Results A total of 465 patients (68% male; mean age 52.3±15 years, range 25 to 80 years) were enrolled in the study, including
265 in fondaparinux group and 200 in LMWH group. Anticoagulation-related complications were observed in 3 patients in
fondaparinux group, as compared with 13 in LMWH group (P=0.002), but the thromboembolic rate did not differ significantly
between the two groups (P=0.111). Two patients in fondaparinux group and 8 in LMWH group showed bleeding complications
(P=0.039). No cardiovascular death occwrred in these patients during a mean follow-up period of 3 months. Conclusions
Fondaparinux as the bridging therapy during catheter ablation for AF does not increase the risk of thromboembolic
complications but slightly reduces the risk of bleeding compared to LMWH, suggesting its safety and effectiveness for
periprocedural anticoagulation management in AF patients undergoing radiofrequency ablation.