Very Low Risk of Thromboembolic Events in Patients Undergoing Successful Catheter Ablation of Atrial Fibrillation With a CHADS ₂ Score ≤3

Abstract

Background-Long-term cessation of oral anticoagulation (OAC) after catheter ablation of atrial fibrillation (AF) has been deemed controversial.

Late-Phase Thromboembolism After Catheter Ablation for Paroxysmal Atrial Fibrillation

“…tients (94%) and was discontinued mostly in low-risk patients (CHADS2 score =0 or 1). 6 In the present study, the incidence of TE was higher than in those 2 studies. Although the discrepancy in the results may be partially attributed to the differences in the subjects and the follow-up period, the prevalence of antiplatelet therapy after the cessation of anticoagulation therapy may have potentially influenced the outcome.…”

“…[4][5][6][7] The largest reported series was published by Themistoclakis et al in a multicenter retrospective analysis of 3,355 patients, wherein 18% had CHADS2 score ≥2, and the mean follow-up tomatic AF episodes could have been missed in these patients, and the actual recurrence rate of AF could have been higher. Although we must have obtained the precise incidence of symptomatic late-phase TE given that we had conducted a thorough annual telephone interview of patients and their families, we may have missed patients with silent ischemic stroke.…”

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…857 OAC and AADs were discontinued irrespective of AF type or baseline CHA 2 DS 2 -VASc risk score in 327 patients with drug-refractory AF after catheter ablation. Patients with a CHA 2 DS 2 -VASc score of 2 (45.4%) and 3 (23.2%) accounted for 68.8% of this cohort.…”

Periprocedural Anticoagulation of Patients Undergoing Pericardiocentesis for Cardiac Tamponade Complicating Catheter Ablation of Atrial Fibrillation

“…[29][30][31] In the present series, those patients with AF recurrence and a CHADS 2 score ≥ 2 continued the oral warfarin after three months, while the others were given antiplatelet treatment instead. More attention must be paid to achieving the optimal safe level of anticoagulation throughout the process.…”