Why the study?
This post-hoc analysis aimed to evaluate the optimal OAC strategy after AF ablation among patient groups stratified by left atrial diameter.
Does discontinuation of oral anticoagulation reduce the composite of stroke, systemic embolism, or major bleeding in patients without recurrent atrial arrhythmia 1 year after AF ablation, regardless of left atrial diameter?
Population
840 AF patients with >=1 stroke risk factor and no arrhythmia recurrence for >=1 year post-ablation
Comparison
Discontinue OAC vs continue OAC across left atrial diameter strata (<40 mm vs >=40 mm)
Design
Post-hoc analysis of a randomized trial
Follow-up
2 years
Key result
Discontinuing oral anticoagulation 1 year post-ablation showed no significant difference in stroke, embolism, or major bleeding versus continuing therapy across left atrial diameter strata.
Authors
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Supports OAC discontinuation in LAD<40 mm to reduce composite events; extends RCT evidence for tailored post-ablation strategies.
Does discontinuation of oral anticoagulation reduce the composite of stroke, systemic embolism, or major bleeding in patients without recurrent atrial arrhythmia 1 year after AF ablation, regardless of left atrial diameter?
Discontinuation of oral anticoagulation 1 year after successful AF ablation appears safe and is not significantly influenced by left atrial diameter, suggesting rhythm status is more important than structural remodeling for OAC decisions.
Kim et al. (2026) studied this question. Discontinuing oral anticoagulation 1 year post-ablation showed no significant difference in stroke, embolism, or major bleeding versus continuing therapy across left atrial diameter strata.