{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:11:39Z","timestamp":1778069499529,"version":"3.51.4"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"Supplement_5","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Two randomized trials, the ALONE-AF and OCEAN, have provided valuable evidence to guide the management of oral anticoagulation therapy after ablation of atrial fibrillation. In the ALONE-AF study, amongst patients with no documented atrial fibrillation recurrence at 1 year after transcatheter ablation, the 2-year incidence of the composite endpoint of stroke, systemic embolism, and major bleeding was significantly lower in those who discontinued oral anticoagulation compared with those who continued therapy. This difference was driven by a reduction in major bleeding events, with similar rates of stroke between groups. In the OCEAN study, amongst patients without atrial fibrillation (AF) recurrence during the year following transcatheter ablation, rivaroxaban 15 mg, compared with acetylsalicylic acid (ASA), did not significantly reduce the 3-year incidence of stroke, systemic embolism, or new silent embolic cerebral infarction, but was associated with an increased risk of clinically relevant non-major bleeding. The annualized incidence of thromboembolic events was low (0.3\u20130.6 events per 100 patient-years). Taken together, data from these two trials suggest that discontinuation of oral anticoagulation (OAC) may be a clinically reasonable option in patients without AF recurrence for at least 1 year after ablation. This strategy should be limited to patients at low thromboembolic risk, comparable to those enrolled in the two trials. Furthermore, the implementation of optimal and sustainable rhythmmonitoring strategies is essential to support decisions regarding OAC discontinuation after AF ablation.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suag026","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T12:45:18Z","timestamp":1772023518000},"page":"v73-v76","source":"Crossref","is-referenced-by-count":0,"title":["Discontinuation of anticoagulation therapy after atrial fibrillation ablation: the ALONE-AF and OCEAN studies"],"prefix":"10.1093","volume":"28","author":[{"given":"Mario","family":"Campisi","sequence":"first","affiliation":[{"name":"Division of Cardiology, Gaetano Martino University Hospital, University of Messina , Messina ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florinda","family":"Bonanno","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Gaetano Martino University Hospital, University of Messina , Messina ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8434-7367","authenticated-orcid":false,"given":"Piera","family":"Capranzano","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Policlinico University Hospital, University of Catania , S. Sofia 78, 95123 Catania ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"2026050607112942200_suag026-B1","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early rhythm-control therapy in patients with atrial fibrillation","volume":"383","author":"Kirchhof","year":"2020","journal-title":"N Engl J Med"},{"key":"2026050607112942200_suag026-B2","doi-asserted-by":"crossref","first-page":"3105","DOI":"10.1016\/j.jacc.2020.04.065","article-title":"Recurrence of atrial fibrillation after catheter ablation or antiarrhythmic drug therapy in the CABANA trial","volume":"75","author":"Poole","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026050607112942200_suag026-B3","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1001\/jama.2019.0693","article-title":"Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial","volume":"321","author":"Packer","year":"2019","journal-title":"JAMA"},{"key":"2026050607112942200_suag026-B4","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1093\/eurheartj\/ehad798","article-title":"Oral anticoagulation after atrial fibrillation catheter ablation: benefits and risks","volume":"45","author":"Kanaoka","year":"2024","journal-title":"Eur Heart J"},{"key":"2026050607112942200_suag026-B5","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1111\/jce.14052","article-title":"Oral anticoagulation after catheter ablation of atrial fibrillation and the associated risk of thromboembolic events and intracranial hemorrhage: a systematic review and meta-analysis","volume":"30","author":"Romero","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026050607112942200_suag026-B6","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1111\/jce.13822","article-title":"Anticoagulation after catheter ablation of atrial fibrillation: an unnecessary evil? A systematic review and meta-analysis","volume":"30","author":"Proietti","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026050607112942200_suag026-B7","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":"2026050607112942200_suag026-B8","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1001\/jama.2025.14679","article-title":"Long-term anticoagulation discontinuation after catheter ablation for atrial fibrillation: the ALONE-AF randomized clinical trial","volume":"334","author":"Kim","year":"2025","journal-title":"JAMA"},{"key":"2026050607112942200_suag026-B9","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1056\/NEJMoa2509688","article-title":"Antithrombotic therapy after successful catheter ablation for atrial fibrillation","volume":"394","author":"Verma","year":"2026","journal-title":"N Engl J Med"},{"key":"2026050607112942200_suag026-B10","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1056\/NEJMoa2310234","article-title":"Apixaban for stroke prevention in subclinical atrial fibrillation","volume":"390","author":"Healey","year":"2024","journal-title":"N Engl J Med"},{"key":"2026050607112942200_suag026-B11","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1056\/NEJMoa2303062","article-title":"Anticoagulation with edoxaban in patients with atrial high-rate episodes","volume":"389","author":"Kirchhof","year":"2023","journal-title":"N Engl J Med"},{"key":"2026050607112942200_suag026-B12","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.jacc.2024.05.002","article-title":"Apixaban vs aspirin according to CHA2DS-VASc score in subclinical atrial fibrillation: insights from ARTESIA","volume":"84","author":"Lopes","year":"2024","journal-title":"J AM Coll Cardiol"},{"key":"2026050607112942200_suag026-B13","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.hrthm.2014.02.003","article-title":"Very long-term outcome after initially successful catheter ablation of atrial fibrillation","volume":"11","author":"Steinberg","year":"2014","journal-title":"Heart Rhythm"}],"container-title":["European Heart Journal Supplements"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/advance-article-pdf\/doi\/10.1093\/eurheartjsupp\/suag026\/67290821\/suag026.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/28\/Supplement_5\/v73\/67290821\/suag026.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/28\/Supplement_5\/v73\/67290821\/suag026.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:11:33Z","timestamp":1778065893000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article\/28\/Supplement_5\/v73\/8513303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":13,"journal-issue":{"issue":"Supplement_5","published-online":{"date-parts":[[2026,3,11]]},"published-print":{"date-parts":[[2026,5,6]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartjsupp\/suag026","relation":{},"ISSN":["1520-765X","1554-2815"],"issn-type":[{"value":"1520-765X","type":"print"},{"value":"1554-2815","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,3,11]]}}}