Researchers revealed the benefits and risks of continuing oral anticoagulation therapy after catheter ablation for atrial fibrillation according to the thromboembolic risk.

 

Researchers in National Cerebral and Cardiovascular Center have just published the study “Oral anticoagulation after atrial fibrillation catheter ablation: benefits and risks” online in the international academic journal, European Heart Journal on 19th December 2023.
https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehad798

 

Catheter ablation for atrial fibrillation (AF) has become a common procedure worldwide. An expert consensus statement on catheter ablation for AF recommends the continuation of oral anticoagulants after the post-ablation period should be based on the patient’s risk of stroke and preferences; however, few recent large studies are focusing on the risks and benefits of continuing oral anticoagulation therapy after catheter ablation for AF.

A team of researchers, led by Dr. Yoshitaka Iwanaga, performed a nationwide cohort study using administrative data that covers almost all healthcare insurance in Japan and analyzed the rate of continuing oral anticoagulants after catheter ablation and the occurrence of thromboembolic and major bleeding events related to the oral anticoagulation therapy according to the thromboembolic risk. At 6 months and 1 year after the catheter ablation, 71% and 53% of the patients continued oral anticoagulation therapy, respectively, and its rate was higher in the higher CHADS₂ score group than in the lower CHADS₂ score group (Figure). Continuing oral anticoagulation therapy after 6 months postoperatively for catheter ablation was associated with a higher risk of major in patients with a CHADS₂ score of ≤ 2 and was associated with a lower risk of thromboembolism in patients with a CHADS₂ score of ≥ 3.

 

“A substantial number of patients continued their oral anticoagulation therapy after catheter ablation for AF in Japan, but our results support the discontinuation strategy of oral anticoagulants after catheter ablation in patients with a lower thromboembolic risk.” – Dr. Koshiro Kanaoka

 

This research could provide critical insights for healthcare providers when considering whether to continue oral anticoagulant therapy after catheter ablation for AF.

Figure. Continuation of oral anticoagulation therapy after a first-time catheter ablation and the benefits and risks of continuing oral anticoagulation therapy after catheter ablation for AF.

*CHADS2 score: Score estimating the risk of stroke in patients with AF (min: 0 – max: 6 points).

last updated：2023/12/20