Is it safe to stop oral anticoagulation after catheter ablation for atrial fibrillation?

INTRODUCTION: Atrial fibrillation is the most common arrhythmia worldwide. Its increasing prevalence has made the use of oral anticoagulants for stroke prevention routine; however, their use after the blanking period of catheter ablation remains uncertain. Areas covered: This review outlines the pros and cons of stopping oral anticoagulation after catheter ablation. Major databases such as Pubmed or Embase were used. The most relevant articles published were used along with major recommendations of society guidelines. Authors will also discuss different proposed mechanisms of atrial fibrillation and more importantly future directions in this topic. Expert commentary: The use of oral anticoagulants after catheter ablation for atrial fibrillation is debatable; however, based on current guidelines, we support the use of oral anticoagulants after the blanking period of catheter ablation. Noteworthy is that although the risk of bleeding can be fatal in some cases, it does not outweigh the risk of a disabling stroke.