{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:41:55Z","timestamp":1792676515341,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients with left atrial appendage (LAAO) devices are increasingly referred for atrial fibrillation (AF) ablation, yet anticoagulation strategies remain uncertain. The goal of this study was to evaluate the safety and efficacy of catheter ablation for AF in patients with pre-existing LAAO devices and to describe patterns in anticoagulation management after ablation in this unique population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We collected data from 14 centres worldwide on patients with prior LAAO devices undergoing AF ablation. Each site provided clinical characteristics, procedural details, and information on complications and arrhythmia outcomes. Data were aggregated and analysed centrally to evaluate procedural safety, efficacy, and variability in management strategies. A total of 198 patients (age 70 years, 37% female, 42% paroxysmal AF) with prior LAAO were included. Ablation was performed a median of 271 days after LAAO. After ablation, 84% of patients were on oral anticoagulation (OAC), most commonly for 2\u20133 months. Bleeding complications on OAC occurred in 6.7% of patients at a median of 20 (13, 70) days after ablation. Stroke or TIA occurred in five patients (2.6% of cases) within the follow-up period with two occurrences (1% of cases) the day after ablation. There were two cases of new or worsened peri-device leak after ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a large, international registry of patients undergoing catheter ablation for AF with pre-existing LAAO devices, ablation was feasible, and device related complications were rare. Despite higher bleeding risk in an LAAO population, 84% of patients with prior LAAO tolerated short-term OAC post-ablation with bleeding events at expected rates for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag277","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:48:13Z","timestamp":1790318893000},"source":"Crossref","is-referenced-by-count":0,"title":["Safety and efficacy of left atrial ablation after percutaneous left atrial appendage occlusion in high-bleeding-risk patients with atrial fibrillation: a multicentre analysis from the PROCEED-AF ablation registry"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0038-9231","authenticated-orcid":false,"given":"Rachel M","family":"Kaplan","sequence":"first","affiliation":[{"name":"Medical University of South Carolina Department of Cardiology, , 30 Courtenay Dr, Charleston, SC 29414 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-1786","authenticated-orcid":false,"given":"Jeanne","family":"du Fay de Lavallaz","sequence":"additional","affiliation":[{"name":"University of Michigan Department of Cardiology, , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9014-8097","authenticated-orcid":false,"given":"Christian-Hendrik","family":"Heeger","sequence":"additional","affiliation":[{"name":"University of Luebeck Department of Cardiology, , Luebeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Oral","sequence":"additional","affiliation":[{"name":"University of Michigan Department of Cardiology, , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4867-7382","authenticated-orcid":false,"given":"Mason","family":"Yoder","sequence":"additional","affiliation":[{"name":"University of Michigan Department of Cardiology, , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4188-3447","authenticated-orcid":false,"given":"David","family":"Schaack","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien Frankfurt Department of Cardiology, , Frankfurt ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-6015","authenticated-orcid":false,"given":"Julian K","family":"Chun","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien Frankfurt Department of Cardiology, , Frankfurt ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-9906","authenticated-orcid":false,"given":"Boris","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien Frankfurt Department of Cardiology, , Frankfurt ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4537-7555","authenticated-orcid":false,"given":"Jeffrey","family":"Winterfield","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina Department of Cardiology, , 30 Courtenay Dr, Charleston, SC 29414 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8556-3612","authenticated-orcid":false,"given":"William H","family":"Sauer","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Department of Cardiology, , Boston, MA 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