{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:32:21Z","timestamp":1788237141269,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The relationship between oral anticoagulant (OAC) status after catheter ablation (CA) for atrial fibrillation (AF) and the risks of ischemic stroke or major bleeding events is still unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a subanalysis of the RYOUMA registry, a prospective multicenter observational study of Japanese patients who underwent CA for AF in 2017\u20132018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 2844 patients, the rate of DOAC continuation was 48.1%, 69.6%, and 80.9% in patients with a CHADS2 score of 0\u20131, 2, and 3\u20136, respectively. Among the patients taking DOACs with a CHADS2 score of 0\u20131 and 2, the incidence rates of major bleeding were significantly higher than those of ischemic stroke or systemic embolic events (SEEs) (1.3%\/year [95% CI, 0.6\u20132.1] vs. 0.3%\/year [95% CI, 0.0\u20130.7], <jats:italic>p<\/jats:italic>\u2009=\u20090.019; 1.8%\/year [95% CI, 0.6\u20133.0] vs. 0.2%\/year [95% CI, 0.0\u20130.6], <jats:italic>p<\/jats:italic>\u2009=\u20090.018, respectively). However, there was no difference between the incidence rates of major bleeding events and ischemic stroke or SEEs in patients taking DOACs with a CHADS2 score of 3\u20136 (1.6%\/year [95% CI, 0.2\u20133.0] vs. 1.0%\/year [95% CI, 0.0\u20132.1], <jats:italic>p<\/jats:italic>\u2009=\u20090.474).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with a CHADS2 score of 2, those who continued taking DOACs had a higher incidence rate of major bleeding events compared to ischemic stroke\/SEEs, similar to those with a CHADS2 score of 0\u20131. Conversely, in patients with a CHADS2 score of 3\u20136, the incidence rates of both ischemic stroke\/SEEs and major bleeding were similarly high.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> The study was registered as UMIN000026092 (University Hospital Medical Information Network\u2010Clinical Trial Registry)<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.70067","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T20:06:43Z","timestamp":1743797203000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Assessment of Long\u2010Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation\u2014<scp>RYOUMA<\/scp> Registry Subanalysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9113-5987","authenticated-orcid":false,"given":"Yuka","family":"Oda","sequence":"first","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0359-4601","authenticated-orcid":false,"given":"Akihiko","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba  Tsukuba Japan"},{"name":"Department of Cardiology Tokyo Heart Rhythm Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0685-4563","authenticated-orcid":false,"given":"Kyoko","family":"Soejima","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kyorin University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1444-090X","authenticated-orcid":false,"given":"Itsuro","family":"Morishima","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ogaki Municipal Hospital  Ogaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Hiroshima","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Kokura Memorial Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9989-8708","authenticated-orcid":false,"given":"Ritsushi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Arrhythmia Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Sakagami","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Kanazawa Medical Center  Kanazawa Ishikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiharu","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hiroshima Prefectural Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9052-374X","authenticated-orcid":false,"given":"Keisuke","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kagawa Prefectural Central Hospital  Takamatsu Kagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"Primary Medical Science Department DAIICHI SANKYO co., Ltd.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Takita","sequence":"additional","affiliation":[{"name":"Data Intelligence Department DAIICHI SANKYO co., Ltd.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kikuya","family":"Uno","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Heart Rhythm Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2507-5565","authenticated-orcid":false,"given":"Koichiro","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center Fukuoka Sanno Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2983-0732","authenticated-orcid":false,"given":"Takashi","family":"Kurita","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Center Kindai University School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5973-9163","authenticated-orcid":false,"given":"Masahiko","family":"Gosho","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Faculty of Medicine, University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3794-899X","authenticated-orcid":false,"given":"Tomoko","family":"Ishizu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Aonuma","sequence":"additional","affiliation":[{"name":"Department of Cardiology Institute of Medicine, University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the RYOUMA Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.4022\/jafib.2092"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad798"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu421"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253709"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12491"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-22-0290"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz235"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.70067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:06:15Z","timestamp":1748333175000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.70067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/anec.70067"],"URL":"https:\/\/doi.org\/10.1111\/anec.70067","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"value":"1082-720X","type":"print"},{"value":"1542-474X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"assertion":[{"value":"2024-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70067"}}