{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:54:00Z","timestamp":1791546840601,"version":"4.3.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["26POST1567675"],"award-info":[{"award-number":["26POST1567675"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG075335"],"award-info":[{"award-number":["R01AG075335"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1RF1AG063381-01"],"award-info":[{"award-number":["1RF1AG063381-01"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005294","name":"Shoolman Fund of the Massachusetts General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005294","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Guidelines recommend continuing oral anticoagulation (OAC) after atrial fibrillation (AF) ablation based on stroke risk, yet real-world post-procedural OAC management remains poorly characterized. We aimed to evaluate contemporary patterns of OAC use after AF ablation and identify predictors of OAC discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Using Medicare claims from 2013\u20132022, we established a cohort of patients undergoing a first AF ablation and assessed patterns of OAC discontinuation during the subsequent year. We defined OAC discontinuation as a dispensing gap \u226560 days. Baseline characteristics were evaluated as predictors of discontinuation using least absolute shrinkage and selection operator Cox regression. Among 208 232 AF patients (mean age 74.5, 47% women) undergoing ablation, 58% were taking OAC following ablation, 24% discontinued between 3 and 12 months, 8% discontinued within 3 months, and 10% did not use OAC within 3 months. Apixaban was the most commonly used OAC agent, while the use of warfarin declined over time. The overall rate of repeated ablation was 26%. We found that 44% of patients with CHA2DS2-VASc score \u22653 discontinued OAC within 1 year after ablation. Higher CHA2DS2-VASc scores and longer pre-ablation OAC use were associated with lower discontinuation, whereas pre-ablation major bleeding, frailty, and use of warfarin (vs. direct OACs) increased the likelihood of discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OAC discontinuation after AF ablation is common, including among patients at elevated stroke risk despite guideline recommendations for continued therapy. More data are needed on the clinical consequences of post-ablation OAC discontinuation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeag128","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:15:30Z","timestamp":1786965330000},"source":"Crossref","is-referenced-by-count":0,"title":["Discontinuation of oral anticoagulants is common after catheter ablation in older patients with atrial fibrillation"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6429-5982","authenticated-orcid":false,"given":"Xiaojuan","family":"Liu","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School , 399 Revolution Drive, Somerville, Boston, MA 02145 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6145-4848","authenticated-orcid":false,"given":"Daniel E","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School , 100 Cambridge Street, Boston, MA 02114 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5605-4724","authenticated-orcid":false,"given":"E Kevin","family":"Heist","sequence":"additional","affiliation":[{"name":"Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Harvard Medical School , 55 Fruit Street, Boston, MA 02114 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kueiyu Joshua","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School , 399 Revolution Drive, Somerville, Boston, MA 02145 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026100907263377700_oeag128-B1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"2026100907263377700_oeag128-B2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice 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Cardiol"},{"key":"2026100907263377700_oeag128-B5","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/eurheartj\/eht457","article-title":"Catheter ablation vs. antiarrhythmic drug treatment of persistent atrial fibrillation: a multicentre, randomized, controlled trial (SARA study)","volume":"35","author":"Mont","year":"2014","journal-title":"Eur Heart J"},{"key":"2026100907263377700_oeag128-B6","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1001\/jama.2009.2029","article-title":"Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial","volume":"303","author":"Wilber","year":"2010","journal-title":"JAMA"},{"key":"2026100907263377700_oeag128-B7","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1001\/jama.2014.467","article-title":"Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a 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(DISCERN AF): a prospective, multicenter study","volume":"173","author":"Verma","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2026100907263377700_oeag128-B11","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.115.002597","article-title":"Patterns of anticoagulation use and cardioembolic risk after catheter ablation for atrial fibrillation","volume":"4","author":"Noseworthy","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"2026100907263377700_oeag128-B12","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.119.007612","article-title":"Outcomes and anticoagulation use after catheter ablation for atrial fibrillation","volume":"12","author":"Freeman","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026100907263377700_oeag128-B13","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.123.010279","article-title":"Patient characteristics associated with using transcatheter left atrial appendage occlusion versus oral anticoagulants for atrial 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