“…However, the rates of ischemic stroke did not differ significantly between the OAC vs no OAC groups nor between the AF vs no AF groups. Yamamoto et al 1 emphasize that the influence on mortality was much greater with bleeding than ischemic stroke; at 3 years, 7.4% with bleeding versus 3.4% with ischemic stroke. The implication is that—in the context of TAVR—one must reconsider the paradigm of OAC even in the presence of AF, or one must consider alternatives such as left atrial appendage closure, which is the subject of ongoing studies.…”