{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:07:05Z","timestamp":1791389225169,"version":"4.3.3"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Whether long\u2010term oral anticoagulation (OAC) is necessary after apparently successful atrial fibrillation (AF) ablation remains uncertain. Guidelines recommend continuation based on CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score rather than procedural success, yet contemporary evidence, including randomized trials, has produced conflicting results. We aimed to provide an updated and comprehensive assessment of OAC discontinuation following AF ablation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis in patients who discontinued versus continued OAC after AF ablation. Outcomes included thromboembolic events (TE) and major bleeding events (MBE). Random\u2010effects models with Hartung\u2013Knapp correction were applied. Heterogeneity, publication bias, influence analyses, subgroup analyses, and risk\u2010of\u2010bias domains were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 28 studies (267\u2009443 patients), OAC discontinuation significantly reduced the composite of TE and MBE (RR 0.44, 95% CI 0.32\u20130.61), driven by a marked decrease in bleeding (RR 0.25, 95% CI 0.16\u20130.39), without excess thromboembolic risk (RR 0.84, 95% CI 0.64\u20131.12). Findings remained consistent across subgroup analyses (study design, CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc, geographic region), with sensitivity and meta\u2010regression confirming robustness and no significant effect modifiers. Funnel plots showed no significant asymmetry for TE, whereas MBE demonstrated evidence of small\u2010study effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Discontinuation of OAC after successful AF ablation markedly reduces MBE without a statistically significant increase in TE, highlighting the need for individualized post\u2010ablation anticoagulation strategies. Randomized trials are needed to confirm the safety of tailored oral anticoagulant discontinuation in selected patients, supported by careful long\u2010term follow\u2010up and shared decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ejh.70155","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:23:56Z","timestamp":1772990636000},"page":"915-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Oral Anticoagulation After Atrial Fibrillation Ablation: An Updated Systematic Review and Meta\u2010Analysis of 267\u2009443 Patients"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8831-6178","authenticated-orcid":false,"given":"Andrea","family":"Matteucci","sequence":"first","affiliation":[{"name":"Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital  Rome Italy"},{"name":"Department of Experimental Medicine Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9480-1209","authenticated-orcid":false,"given":"Marco Valerio","family":"Mariani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Pandozi","sequence":"additional","affiliation":[{"name":"Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Bonanni","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6543-7567","authenticated-orcid":false,"given":"Marco","family":"Frazzetto","sequence":"additional","affiliation":[{"name":"Cardiocentro Ticino Department of Cardiology  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pierucci","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7548-4685","authenticated-orcid":false,"given":"Vincenzo Mirco","family":"La Fazia","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine Tor Vergata University  Rome Italy"},{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele Maria","family":"Bruti","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5092-3115","authenticated-orcid":false,"given":"Marta","family":"Palombi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vernile","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Lavalle","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine Dario","family":"Vizza","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Fedele","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology UOC Cardiologia, Sandro Pertini Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Nardi","sequence":"additional","affiliation":[{"name":"Santo Spirito Hospital  Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furio","family":"Colivicchi","sequence":"additional","affiliation":[{"name":"Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.641225"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.10.044"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/10760296221118480"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253709"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13822"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.14679"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2509688"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.039"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-11-0065"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.963231"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.962100"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-300720"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02141.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-013-9835-1"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut406"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu421"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13138"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-19-0602"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.08.005"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz235"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm-20-565"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.18\u2010517"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.4179"},{"key":"e_1_2_12_27_1","unstructured":"M. P.Riley E.Zado M. D.Hutchinson et\u00a0al. Risk of stroke or transient ischemic attack after atrial fibrillation ablation with oral anticoagulant use guided by ECG monitoring and pulse assessment: oral anticoagulant use after AF ablation."},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13476"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000311"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2014.55.5.1238"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2009.01481.x"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.1320"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.4103\/ACCJ.ACCJ_5_23"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf784.457"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad798"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e32516"},{"key":"e_1_2_12_37_1","unstructured":"https:\/\/clinicaltrials.gov\/study\/NCT06615596."}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70155","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ejh.70155","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:04:39Z","timestamp":1777982679000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.70155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/ejh.70155"],"URL":"https:\/\/doi.org\/10.1111\/ejh.70155","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]},"assertion":[{"value":"2026-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}