{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:45:54Z","timestamp":1782906354868,"version":"3.54.5"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Life-long direct oral anticoagulant (DOAC) therapy is recommended after catheter ablation for atrial fibrillation (AF) in high-risk patients (CHA2DS2-VA\u22652). Long-term DOAC compliance is crucial for effective stroke prevention. This study seeks to evaluate long-term compliance measured by adherence and persistence to DOAC therapy following first-time catheter abltation for AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>All Danish patients undergoing first-time catheter ablation between 2017 and 2024 were identified through Danish registries. Patients were stratified by CHA2DS2-VA score 0, 1, and \u22652. Primary outcomes were adherence and persistence to DOAC therapy at 1, 2, and 3 years after first-time catheter ablation. Adherence was defined as the proportion of days covered (PDC) \u226580%. Persistence was assessed as the proportion of patients covered based on the most recent pharmacy redemption before specific time points, given a 20% grace period. A total of 13 438 patients (32.1% female) were included. At 3 years post-ablation, the proportion of adherent patients with CHA2DS2-VA \u22652 (n = 7322) was 87.6% [95% cinfidence interval (CI): 86.8\u201388.4]. Applying a sensitivity analysis with a PDC \u226590% threshold, the proportion was 78.8% (95% CI: 77.8\u201379.8%). Persistence was 73.0% (95% CI: 71.6\u201374.4%) at 3 years. Rates of thromboembolic outcomes were low with a total incidence rate of the combined outcome of ischaemic stroke, transient ischaemic attack and systemic embolism at 6.6 per 1000 person-years (95% CI: 5.8\u20137.4). The incidence of major bleeding was found at 7.1 per 1000 person-years (95% CI: 6.3\u20138.0) for the combined cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While adherence to DOAC therapy was acceptable in patients with CHA2DS2-VA\u22652, persistence declined over time and more than 20% were non-persistent by 3 years. Efforts to improve effective long-term stroke prevention may be warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Unstructured abstract<\/jats:title>\n                    <jats:p>Life-long direct oral anticoagulant (DOAC) therapy is recommended after catheter ablation for atrial fibrillation in high-risk patients (CHA2DS2-VA\u22652). Adherence and persistence to DOAC is crucial for effective stroke prevention.<\/jats:p>\n                    <jats:p>Danish patients undergoing first-time catheter ablation between 2017 and 2024 were identified through registries.<\/jats:p>\n                    <jats:p>A total of 13 438 patients were included. At 3 years post-ablation, the proportion of adherent and persistent patients with CHA2DS2-VA \u22652 (n = 7322) was 87.6% and 73.0%, respectively.<\/jats:p>\n                    <jats:p>Adherence to DOAC was acceptable in patients with CHA2DS2-VA\u22652. More than 20% of patients were non-persistent by 3 years. Efforts to improve effective long-term stroke prevention may be warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag151","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:09:53Z","timestamp":1781611793000},"source":"Crossref","is-referenced-by-count":0,"title":["Compliance to direct oral anticoagulation therapy and clinical outcomes after catheter ablation for atrial fibrillation: a nationwide cohort study"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4523-4193","authenticated-orcid":false,"given":"Bjarke Sihm","family":"Stender","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, Aarhus N, Aarhus DK-8200 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8348-7261","authenticated-orcid":false,"given":"Victor Kj\u00e6r","family":"Eskildsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, Aarhus N, Aarhus DK-8200 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5546-8693","authenticated-orcid":false,"given":"Anders","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, Aarhus N, Aarhus DK-8200 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja Hellfritzsch","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, Aarhus N, Aarhus DK-8200 ,","place":["Denmark"]},{"name":"Department of Cardiology, Regional Hospital G\u00f8dstrup , Herning ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4724-0880","authenticated-orcid":false,"given":"Kasper","family":"Korsholm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Palle Juul-Jensens Boulevard 99, Aarhus N, Aarhus DK-8200 ,","place":["Denmark"]},{"name":"Department of Cardiology, Regional Hospital G\u00f8dstrup , Herning ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8626-2372","authenticated-orcid":false,"given":"Kasper","family":"Bonnesen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg , Copenhagen 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