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Updated: Feb 13, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

34.2K

Anticoagulation use and clinical outcomes after catheter ablation in patients with persistent and longstanding

Jackson J Liang1, Melissa A Elafros2, Michael T Mullen3

  • 1Cardiovascular Division, Electrophysiology Section, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Journal of Cardiovascular Electrophysiology
|March 8, 2018
PubMed

Insights

Successful catheter ablation for atrial fibrillation (AF) may allow safe discontinuation of oral anticoagulation therapy (OAT) in selected patients, showing low rates of cerebrovascular events (CVEs). Further studies are needed to confirm safety after AF ablation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Vascular Medicine

Background:

  • Atrial fibrillation (AF) ablation success in reducing cerebrovascular events (CVEs) is debated.
  • Safe discontinuation of oral anticoagulation therapy (OAT) after AF ablation remains unclear.

Purpose of the Study:

  • Evaluate OAT use patterns post-ablation.
  • Examine long-term rates of CVEs and major bleeding episodes (MBEs) in nonparoxysmal AF patients treated with catheter ablation.

Main Methods:

  • Followed 400 patients with nonparoxysmal AF (persistent and longstanding persistent) for 3.6 years post-ablation.
  • Permitted OAT discontinuation at physician discretion; analyzed AF recurrence, OAT status, CVEs, and MBEs.
  • Used Cox regression to identify factors influencing OAT continuation and CVE risk.

Main Results:

  • 43% of patients were free of AF recurrence; 43.5% were off OAT at last follow-up.
  • No AF recurrence was linked to higher likelihood of OAT discontinuation (HR 0.23).
  • CVE incidence was 0.49/100 patient-years; MBE incidence was 0.98/100 patient-years. Older age and CAD increased CVE risk.

Conclusions:

  • Discontinuing OAT in selected, monitored patients post-successful nonparoxysmal AF ablation showed low CVE rates.
  • Prospective research is essential to validate OAT discontinuation safety after AF ablation.
Abstract

Keywords:
anticoagulationatrial fibrillationbleedcatheter ablationcerebrovascularpulmonary vein isolationstroke

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