{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:42:45Z","timestamp":1793659365666,"version":"4.5.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22K20857"],"award-info":[{"award-number":["JP22K20857"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Continuous anticoagulation based on the CHA2DS2\u2010VASc score is recommended to prevent embolism caused by atrial fibrillation (AF), but it does not consider AF episodes. The Apple Watch's continuous heart rhythm monitoring and fast\u2010acting direct oral anticoagulants (DOACs) could enable precise, episode\u2010tailored anticoagulation, reducing bleeding risks while preventing stroke. This study evaluates Apple Watch\u2010guided personalized anticoagulation therapy, adjusting DOAC usage based on real\u2010time AF detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter prospective single\u2010arm study will enroll patients who have maintained sinus rhythm post\u2010ablation and are on DOACs. The target enrollment is 50 patients free of AF for at least 30\u2009days following the initiation of Apple Watch monitoring. If no AF occurs for the first 30\u2009days of monitoring, anticoagulants will be discontinued on day 31. If AF is confirmed after day 31, DOAC administration will be resumed and continued until the end of the observation period. The primary endpoint is the reduction in the total number of days with DOACs from day 31 to day 360 compared to the conventional method of continuing anticoagulation. Secondary endpoints include all\u2010cause mortality, stroke, systemic thromboembolism, bleeding events, and Apple Watch malfunctions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Enrollment of a total of 50 patients was completed in April 2024. Follow\u2010up of the last enrolled patient will be completed in April 2025 and primary results are expected to be available in late 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Up to AF trial is the first trial to evaluate Apple Watch\u2010guided personalized anticoagulation therapy. This trial represents a potential advancement in personalized medicine for AF management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.13194","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T05:48:40Z","timestamp":1733377720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Novel anticoagulation therapy using apple watch after catheter ablation for atrial fibrillation\u2014Up to\n                    <scp>AF<\/scp>\n                    trial: Design and rationale"],"prefix":"10.1002","volume":"41","author":[{"given":"Akihiro","family":"Sunaga","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Sakurabashi Watanabe Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Egami","sequence":"additional","affiliation":[{"name":"Division of Cardiology Osaka Rosai Hospital  Sakai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Minamiguchi","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Osaka Police Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Division of Cardiology Osaka General Medical Center  Osaka 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