Evidence map›Paper›PMID 39817007›Full record

ArticleJournal of arrhythmia2025

Novel anticoagulation therapy using apple watch after catheter ablation for atrial fibrillation-Up to AF trial: Design and rationale.

Akihiro Sunaga, Nobuaki Tanaka, Yasuyuki Egami, Hitoshi Minamiguchi, Takafumi Oka, Masato Kawasaki, Koichi Inoue, Masaharu Masuda, Miwa Miyoshi, Nobuhiko Makino and 11 more

Abstract read
In one paragraph

Article in Journal of arrhythmia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Clinical outcomes of continuing vs. discontinuing oral anticoagulation after atrial fibrillation ablation: an updated systematic review and meta-analysis of observational studies and randomized controlled trials.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 · 2026
    Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Akihiro SunagaDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Nobuaki TanakaCardiovascular Center Sakurabashi Watanabe Hospital Osaka Japan.
Yasuyuki EgamiDivision of Cardiology Osaka Rosai Hospital Sakai Japan.
Hitoshi MinamiguchiCardiovascular Division Osaka Police Hospital Osaka Japan.
Takafumi OkaDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Masato KawasakiDivision of Cardiology Osaka General Medical Center Osaka Japan.
Koichi InoueCardiovascular Division National Hospital Organization Osaka National Hospital Osaka Japan.
Masaharu MasudaCardiovascular Center Kansai Rosai Hospital Amagasaki Japan.
Miwa MiyoshiDepartment of Cardiology Osaka Hospital, Japan Community Healthcare Organization Osaka Japan.
Nobuhiko MakinoDepartment of Cardiology Rinku General Medical Center Izumisano Japan.
Tetsuya WatanabeDivision of Cardiology Osaka General Medical Center Osaka Japan.ORCID https://orcid.org/0000-0003-3979-527X
Daisaku NakataniDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Katsuki OkadaDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Hirota KidaDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Yuki MatsuokaDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Daisuke SakamotoDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
Tetsuhisa KitamuraDepartment of Social and Environmental Medicine Osaka University Graduate School of Medicine Osaka Japan.
Tomomi YamadaDepartment of Medical Innovation Osaka University Hospital Suita Japan.
Yohei SotomiDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.ORCID https://orcid.org/0000-0002-7564-2978
Yasushi SakataDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Osaka Japan.
OCVC‐Arrhythmia Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Continuous anticoagulation based on the CHA2DS2-VASc score is recommended to prevent embolism caused by atrial fibrillation (AF), but it does not consider AF episodes. The Apple Watch's continuous heart rhythm monitoring and fast-acting direct oral anticoagulants (DOACs) could enable precise, episode-tailored anticoagulation, reducing bleeding risks while preventing stroke. This study evaluates Apple Watch-guided personalized anticoagulation therapy, adjusting DOAC usage based on real-time AF detection. Methods: This multicenter prospective single-arm study will enroll patients who have maintained sinus rhythm post-ablation and are on DOACs. The target enrollment is 50 patients free of AF for at least 30 days following the initiation of Apple Watch monitoring. If no AF occurs for the first 30 days of monitoring, anticoagulants will be discontinued on day 31. If AF is confirmed after day 31, DOAC administration will be resumed and continued until the end of the observation period. The primary endpoint is the reduction in the total number of days with DOACs from day 31 to day 360 compared to the conventional method of continuing anticoagulation. Secondary endpoints include all-cause mortality, stroke, systemic thromboembolism, bleeding events, and Apple Watch malfunctions. Results: Enrollment of a total of 50 patients was completed in April 2024. Follow-up of the last enrolled patient will be completed in April 2025 and primary results are expected to be available in late 2025. Conclusions: The Up to AF trial is the first trial to evaluate Apple Watch-guided personalized anticoagulation therapy. This trial represents a potential advancement in personalized medicine for AF management.

Indexed as

Apple Watchatrial fibrillationDOACtailored anticoagulation

Identifiers

PMID39817007
PMCPMC11730706

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.