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

ABSTRACT

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.

KEYWORDS:

• Atrial fibrillation
• catheter ablation
• oral anticoagulation
• stroke
• thromboembolism

Declaration of interest

L Di Biase is a consultant for Biosense Webster, Stereotaxis, Boston Scientific, and Abbott and received speaker honoraria/travel from Medtronic, Pfizer, and Biotronik. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.