{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:49Z","timestamp":1792785889979,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T00:00:00Z","timestamp":1567728000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2016YFC0900901"],"award-info":[{"award-number":["2016YFC0900901"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2016YFC1301002"],"award-info":[{"award-number":["2016YFC1301002"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2017YFC0908803"],"award-info":[{"award-number":["2017YFC0908803"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2018YFC1312501"],"award-info":[{"award-number":["2018YFC1312501"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Science Foundation of China","doi-asserted-by":"publisher","award":["81530016"],"award-info":[{"award-number":["81530016"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["201808110248"],"award-info":[{"award-number":["201808110248"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004331","name":"Johnson & Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Boehringer-Ingelheim"},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to investigate the safety of discontinuing oral anticoagulation (OAC) therapy after apparently successful atrial fibrillation (AF) ablation, using data from the Chinese Atrial Fibrillation Registry study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We identified 4512 consecutive patients who underwent successful AF ablation between August 2011 and December 2017. Of them, 3149 discontinued OAC 3\u2009months post-ablation (Off-OAC group) and 1363 continued OAC beyond this period (On-OAC group). Regular follow-up examinations were undertaken to detect AF recurrence, monitor OAC therapy, and measure clinical outcomes. Primary outcomes included thromboembolic and major bleeding (MB) events experienced beyond 3\u2009months after ablation. Low thromboembolic and MB event rates were noted in the on-treatment analysis. The incidence rates for thromboembolism were 0.54 [95% confidence interval (CI) 0.39\u20130.76] and 0.86 (95% CI 0.56\u20131.30) per 100 patient-years, and that for MB events were 0.19 (95% CI 0.11\u20130.34) and 0.35 (95% CI 0.18\u20130.67) per 100 patient-years, for the Off-OAC and On-OAC groups over mean follow-up periods of 24.2\u2009\u00b1\u200914.7 and 23.0\u2009\u00b1\u200913.6\u2009months, respectively. Similar results were observed in the intention-to-treat analysis. Previous history of ischaemic stroke (IS)\/transient ischaemic attack (TIA)\/systemic embolism (SE) [hazard ratio (HR) 3.40, 95% CI 1.92\u20136.02; P\u2009&amp;lt;\u20090.01] and diabetes mellitus (HR 2.06, 95% CI 1.20\u20133.55, P\u2009=\u20090.01) were independently associated with thromboembolic events, while OAC discontinuation (HR 0.71, 95% CI 0.41\u20131.23, P\u2009=\u20090.21) remained insignificant in multivariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that it may be safe to discontinue OAC in post-ablation patients under diligent monitoring, in the absence of AF recurrence, history of IS\/TIA\/SE, and diabetes mellitus. However, further large-scale randomized trials are required to confirm this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry ChiCTR-OCH-13003729. URL: http:\/\/www.chictr.org.cn\/showproj.aspx?proj=5831.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euz235","type":"journal-article","created":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T15:11:01Z","timestamp":1564585861000},"page":"90-99","source":"Crossref","is-referenced-by-count":70,"title":["The safety of discontinuation of oral anticoagulation therapy after apparently successful atrial fibrillation ablation: a report from the Chinese Atrial Fibrillation Registry study"],"prefix":"10.1093","volume":"22","author":[{"given":"Wang-Yang","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"},{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameenathul M","family":"Fawzy","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Jun","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"San-Shuai","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Yuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song-Nan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ri-Bo","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai-Hua","family":"Sang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Xi","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong-Hui","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-Yong","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Zeng","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Sheng","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,5]]},"reference":[{"key":"2020010703581777600_euz235-B1","doi-asserted-by":"crossref","first-page":"e004549.","DOI":"10.1161\/JAHA.112.004549","article-title":"Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis","volume":"2","author":"Ganesan","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"2020010703581777600_euz235-B2","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1093\/europace\/euw295","article-title":"2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS","volume":"18","author":"Kirchhof","year":"2016","journal-title":"Europace"},{"key":"2020010703581777600_euz235-B3","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/j.hrthm.2013.07.002","article-title":"Atrial fibrillation ablation patients have long-term stroke rates similar to patients without atrial fibrillation regardless of CHADS2 score","volume":"10","author":"Bunch","year":"2013","journal-title":"Heart Rhythm"},{"key":"2020010703581777600_euz235-B4","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.jacc.2009.11.039","article-title":"The risk of thromboembolism and need for oral anticoagulation after successful atrial fibrillation ablation","volume":"55","author":"Themistoclakis","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2020010703581777600_euz235-B5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/eurheartj\/ehu421","article-title":"Oral anticoagulation therapy after radiofrequency ablation of atrial fibrillation and the risk of thromboembolism and serious bleeding: long-term follow-up in nationwide cohort of Denmark","volume":"36","author":"Karasoy","year":"2015","journal-title":"Eur Heart J"},{"key":"2020010703581777600_euz235-B6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/europace\/eux274","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace"},{"key":"2020010703581777600_euz235-B7","doi-asserted-by":"crossref","first-page":"130.","DOI":"10.1186\/s12872-016-0308-1","article-title":"Rationale and design of the Chinese Atrial Fibrillation Registry Study","volume":"16","author":"Du","year":"2016","journal-title":"BMC Cardiovasc Disord"},{"key":"2020010703581777600_euz235-B8","doi-asserted-by":"crossref","first-page":"3223","DOI":"10.1161\/01.CIR.0000131893.41821.D1","article-title":"ACC\/AHA key data elements and definitions for measuring the clinical management and outcomes of patients with atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Data Standards on Atrial Fibrillation)","volume":"109","author":"McNamara","year":"2004","journal-title":"Circulation"},{"key":"2020010703581777600_euz235-B9","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1378\/chest.09-1584","article-title":"Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation","volume":"137","author":"Lip","year":"2010","journal-title":"Chest"},{"key":"2020010703581777600_euz235-B10","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1378\/chest.10-0134","article-title":"A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey","volume":"138","author":"Pisters","year":"2010","journal-title":"Chest"},{"key":"2020010703581777600_euz235-B11","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2005.01204.x","article-title":"Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients","volume":"3","author":"Schulman","year":"2005","journal-title":"J Thromb Haemost"},{"key":"2020010703581777600_euz235-B12","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1093\/eurheartj\/ehw087","article-title":"Catheter ablation for atrial fibrillation is associated with lower incidence of stroke and death: data from Swedish health registries","volume":"37","author":"Friberg","year":"2016","journal-title":"Eur Heart J"},{"key":"2020010703581777600_euz235-B13","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1093\/europace\/eun187","article-title":"Biatrial anatomical reverse remodelling after radiofrequency catheter ablation for atrial fibrillation: evidence from real-time three-dimensional echocardiography","volume":"10","author":"Muller","year":"2008","journal-title":"Europace"},{"key":"2020010703581777600_euz235-B14","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1001\/jamacardio.2016.4179","article-title":"Assessment of use vs discontinuation of oral anticoagulation after pulmonary vein isolation in patients with atrial fibrillation","volume":"2","author":"Sjalander","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2020010703581777600_euz235-B15","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":"2020010703581777600_euz235-B16","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1161\/CIRCOUTCOMES.110.958108","article-title":"Moving the tipping point: the decision to anticoagulate patients with atrial fibrillation","volume":"4","author":"Eckman","year":"2011","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2020010703581777600_euz235-B17","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/jce.12387","article-title":"Risk of stroke or transient ischemic attack after atrial fibrillation ablation with oral anticoagulant use guided by ECG monitoring and pulse assessment","volume":"25","author":"Riley","year":"2014","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2020010703581777600_euz235-B18","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1111\/pace.12625","article-title":"Anticoagulation after catheter ablation of atrial fibrillation guided by implantable cardiac monitors","volume":"38","author":"Zuern","year":"2015","journal-title":"Pacing Clin Electrophysiol"},{"key":"2020010703581777600_euz235-B19","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1093\/eurheartj\/ehn024","article-title":"What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring","volume":"29","author":"Steven","year":"2008","journal-title":"Eur Heart J"},{"key":"2020010703581777600_euz235-B20","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ahj.2017.12.007","article-title":"The Optimal Anti-Coagulation for Enhanced-Risk Patients Post-Catheter Ablation for Atrial Fibrillation (OCEAN) trial","volume":"197","author":"Verma","year":"2018","journal-title":"Am Heart J"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/22\/1\/90\/31721931\/euz235.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/22\/1\/90\/31721931\/euz235.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T04:02:47Z","timestamp":1578369767000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/22\/1\/90\/5561458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,5]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,9,5]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euz235","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,1]]},"published":{"date-parts":[[2019,9,5]]}}}