ArticleIndian pacing and electrophysiology journal
Anticoagulation discontinuation after atrial fibrillation ablation: A systematic review and meta-analysis of randomized and observational evidence.
Article in Indian pacing and electrophysiology journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Anticoagulation discontinuation after atrial fibrillation ablation: reassuring data, but for whom?Indian pacing and electrophysiology journalArticle
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8 authors.
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Abstract
backgroundWhether oral anticoagulation (OAC) can be discontinued after successful atrial fibrillation (AF) ablation remains uncertain. Guidelines recommend continuing OAC based on CHA
objectiveTo synthesize randomized and observational evidence comparing continuation versus discontinuation of OAC after AF ablation.
methodsMEDLINE and Embase were searched from inception through November-2025 for studies comparing continuation versus discontinuation of OAC after the post-ablation blanking period. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Random-effects meta-analysis was conducted. Prespecified subgroup analyses were performed by study design and post-ablation antithrombotic strategy. Leave-one-out sensitivity analyses assessed robustness.
resultsTen studies (3 randomized trials and 7 observational) including 242,083 participants were analyzed. Discontinuation of OAC after AF ablation was not associated with an increased risk of thromboembolic events compared with continued anticoagulation (risk ratio [RR] 0.93; 95% CI 0.86-1.02; I
conclusionAmong patients undergoing AF ablation, discontinuation of OAC was associated with substantially lower bleeding risk without an observed increase in thromboembolic events. Because the available evidence is dominated by observational studies and randomized trials remain small, these findings should not be interpreted as proof of thromboembolic safety. Decisions regarding anticoagulation discontinuation should remain individualized pending results of adequately powered randomized trials.
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