Int J Arrhythm.  2024 Jun;25(2):10. 10.1186/s42444-024-00117-6.

Role of anticoagulation with apixaban in left‑sided atrial tachycardias

• Baig F
• Anwar M
• Khan M
• Kumar A
• Muskan F
• Parkash J
• Karim A
• Ahmed I
• Akhtar W
• Malik J

• KMID: 2557615
• DOI: http://doi.org/10.1186/s42444-024-00117-6

Abstract

Background
Atrial tachycardia poses challenges in patient management due to the associated risks of stroke and systemic embolism. While anticoagulation is recommended in atrial fibrillation (AF), its role in atrial tachycardia remains less defined. This prospective study aimed to evaluate the efficacy and safety of apixaban, a direct oral anticoagulant, in individuals diagnosed with left-sided atrial tachycardias.
Methods
Patients diagnosed with left-sided atrial tachycardia (n = 439) were observed over 3 years. Baseline characteristics, medication regimens, and clinical outcomes were assessed. Apixaban-treated individuals (n = 213) received standard or reduced dosages, while the control group (n = 226) received standard care. Primary outcomes included stroke, systemic embolism, bleeding, and mortality rates.
Results
Baseline characteristics were comparable between groups. The apixaban cohort showed a lower incidence of stroke (7.0% vs. 9.3%, p = 0.027) and decreased all-cause mortality (11.7% vs. 12.8%, p = 0.012) compared to controls. No significant differences were found in major bleeding or systemic embolization between groups.
Conclusion
Apixaban demonstrated a potential benefit in reducing stroke and mortality rates in patients with leftsided atrial tachycardia. While requiring further validation, these findings suggest a potential role for apixaban in anticoagulation strategies for atrial tachycardia management.

Keyword

Atrial tachycardia; Apixaban; Anticoagulation; Stroke prevention; Clinical outcomes