Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry

Abstract

Even in patients with previous stroke, OAC was frequently discontinued during FU after PAF ablation in this observational study. However, TE occurred significantly more frequent in these high-risk patients. These data argue against OAC discontinuation after ablation in patients with previous stroke.

Current Status and Clinical Outcomes of Oral Anticoagulant Discontinuation After Ablation for Atrial Fibrillation in Japan ― Findings From the AF Frontier Ablation Registry ―

“…Numerous investigators have also reported a strong association between advanced age, prior stroke/TIA, high CHADS2, CHA2DS2-VASc, and HAS-BLED scores, and stroke/TIA and major bleeding. [9][10][11][12]20,21 Although some recent studies have shown a significant association between AF recurrence and stroke/TIA events, 22 our study did not. We cannot say with certainty that AF did not recur asymp-continued when, even after AF, the CHA2DS2-VASc score is ≥2.…”

Withdrawal of oral anticoagulants 3 months after successful radiofrequency catheter ablation in patients with atrial fibrillation: A meta‐analysis

“…In a German Ablation Registry observational study, Nuhrich et al 46 have reported that TE occurred more often in the high-risk group This meta-analysis did not identify significant differences in TE between two groups (on-OACs and off-OACs group, Figure 2), which may indicate the feasibility of OACs withdrawal 3 months after successful RFCA for AF. Nevertheless, we detected mild heterogeneity, and consequently preformed subgroup analysis.…”

“…They concluded that continuing OACs indefinitely in high‐risk patients is the safest strategy. In a German Ablation Registry observational study, Nuhrich et al . have reported that TE occurred more often in the high‐risk group (previous stroke) than in the low‐risk group (no previous stroke) (4.3% vs 0.3%, P < 0.05) during a median follow‐up of 489 days.…”

Thromboembolic events, bleeding, and drug discontinuation in patients with atrial fibrillation on anticoagulation: a prospective hospital-based registry

“…The most frequent reason for discontinuation of anticoagulation treatment in our registry was permanent return to sinus rhythm. This group of patients is perceived as a low-risk group and especially after successful ablation treatment, anticoagulation treatment is oftentimes discontinued in clinical practice [20]. There is, however, no evidence supporting a discontinuation of anticoagulation in patients reporting a permanent return to sinus rhythm, because AF may be asymptomatic in nature.…”