ArticleJournal of the American Heart Association2015
Patterns of Anticoagulation Use and Cardioembolic Risk After Catheter Ablation for Atrial Fibrillation.
Article in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Guideline
- Guideline
- Percutaneous left atrial appendage closure following catheter ablation therapy of atrial fibrillation: outcomes stratified by bleeding risk - a sub-analysis of the OPTION study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Trial
- Trial
- Generalizability of the CASTLE-AF trial: Catheter ablation for patients with atrial fibrillation and heart failure in routine practice.Heart rhythm · 2020Trial
- Discontinuation of oral anticoagulants is common after catheter ablation in older patients with atrial fibrillation.European heart journal open · 2026Article
- One Versus Two Months Anticoagulation After Catheter Ablation for Atrial Fibrillation in Patients Who Were Not Indicated for Long-Term OAC: A Pilot Randomized Controlled Trial (The REDUCIBLE Trial).Korean circulation journal · 2026Article
- Same Score, Different Risk: Toward Individualized Anticoagulation After Successful AF Ablation: A Narrative Review for the Post-Ablation Antithrombotic Decision in Atrial Fibrillation.Reviews in cardiovascular medicine · 2026Review
- Post-Catheter Ablation Long-Term Antithrombotic Strategies in Atrial Fibrillation: A Network Meta-Analysis of Randomized Controlled Trials.Circulation. Arrhythmia and electrophysiology · 2026Article
- Esophageal submucosal hematoma associated with apixaban therapy: a case report.Journal of rural medicine : JRM · 2026Article
- Construction of a Multidisciplinary Follow-Up Indicator System Based on the ABC Pathway for Patients with Atrial Fibrillation After Ablation: A Delphi Study.Journal of multidisciplinary healthcare · 2026Article
- Discontinuation of Oral Anticoagulation After Successful Atrial Fibrillation Ablation.JAMA network open · 2025Article
- Novel anticoagulation therapy using apple watch after catheter ablation for atrial fibrillation-Up to AF trial: Design and rationale.Journal of arrhythmia · 2025Article
- Article
- Real world risk of discontinuing oral anticoagulation after successful catheter ablation for atrial fibrillation.Heliyon · 2024Article
- Practical guide on left atrial appendage closure for the non-implanting physician: an international consensus paper.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation.Journal of geriatric cardiology : JGC · 2024Article
- Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is significant practice variation in oral anticoagulation (OAC) use following catheter ablation for atrial fibrillation. It is not clear whether the risk of cardioembolism increases after discontinuation of OAC following catheter ablation. METHODS AND
resultsWe identified 6886 patients within a large national administrative claims database who underwent catheter ablation for atrial fibrillation between January 1, 2005, and September 30, 2014. We assessed the effect of time off of OAC by CHA2DS2-VASc score (after adjusting for other comorbidities) on risk of cardioembolism, using Cox proportional hazards models. There was an increase in the use of non-vitamin K OAC after ablation from 0% in 2005 to 69.8% in 2014. OAC discontinuation was high, with only 60.5% and 31.3% of patients remaining on OAC at 3 and 12 months, respectively. The rate of discontinuation was higher in low-risk patients (82% versus 62.5% at 12 months for CHA2DS2-VASc 0-1 versus ≥2, respectively; P<0.001). Stroke occurred in 1.4% of patients with CHA2DS2-VASc ≥2 and 0.3% of those with CHA2DS2-VASc 0 or 1 over the study follow-up. The risk of cardioembolism in the first 3 months after ablation was increased among those with any time off OAC (hazard ratio 8.06 [95% CI 1.53-42.3], P<0.05). The risk of cardioembolism beyond 3 months was increased with OAC discontinuation among high-risk patients (hazard ratio 2.48 [95% CI 1.11-5.52], P<0.05) but not low-risk patients.
conclusionThe overall risk of stroke in postablation patients is low; however, OAC discontinuation after ablation is common and is associated with increased risk of cardioembolism for all patients within the first 3 months and for high-risk patients in the long term. Continuing OAC for at least 3 months in all patients and indefinitely in high-risk patients appears to be the safest strategy.
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