More Data to Guide Anticoagulation After Ablation for Atrial Fibrillation

Whether and when to stop anticoagulation after ablation for atrial fibrillation (AF) is an open question. Guidelines generally recommend continued anticoagulation, especially if the CHA₂DS₂-VASc score is ≥2, but the risk of stroke should conceivably be lower if the ablation was successful and the patient no longer had AF.

In a randomized open-label trial in South Korea, 840 patients who remained free of AF 1 year after ablation (mostly radiofrequency) were randomized to continue or discontinue oral anticoagulation. Patients were up to 80 years old, per inclusion criteria, with a median CHA₂DS₂-VASc score of 2 (range, 1–3); 68% had paroxysmal AF.