{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:40:33Z","timestamp":1776400833210,"version":"3.51.2"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To evaluate the safety of uninterrupted versus interrupted direct oral anticoagulation (DOAC) for patients undergoing catheter ablation (CA) of atrial fibrillation (AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic search of MEDLINE and EMBASE for randomized controlled trials (RCT) and observational studies comparing uninterrupted versus interrupted DOAC for patients undergoing CA of AF. Primary outcome was major bleeding. Secondary outcomes included minor bleeding, stroke or transient ischemic attack (TIA) or thromboembolism (TE), silent cerebral ischemic events, and cardiac tamponade. Meta\u2010analysis was stratified by study design. Risk ratios (RR) with 95% confidence intervals\u00a0were calculated using random effects model and Mantel\u2013Haenszel method was used to pool RR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 13 studies (7 randomized, 6 observational) comprising 3595 patients were included. The RCT restricted analysis did not show any difference in terms of major bleeding (risk ratio [RR]\u2009=\u20090.79; [0.35\u20131.79]), minor bleeding (RR\u2009=\u20090.99 [0.68\u20131.43]), stroke or TIA or TE (RR\u2009=\u20090.80 [0.19\u20133.32]), silent cerebral ischemic events (RR\u2009=\u20090.64 [0.32\u20131.28]), and cardiac tamponade (RR\u2009=\u20090.61 [0.20\u20131.92]). Observational study restricted analysis showed a protective effect of uninterrupted DOAC on silent cerebral ischemic events (RR\u2009=\u20090.45 [0.31\u20130.67]) and no difference in other outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is no difference in bleeding and thromboembolic outcomes with uninterrupted versus interrupted DOAC for CA of AF and observational data suggests that uninterrupted DOACs are protective against silent cerebral ischemic lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15043","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T00:40:16Z","timestamp":1618620016000},"page":"1995-2004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Uninterrupted versus interrupted direct oral anticoagulation for catheter ablation of atrial fibrillation: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3110-7049","authenticated-orcid":false,"given":"Zain Ul Abideen","family":"Asad","sequence":"first","affiliation":[{"name":"Department of Medicine University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khawaja H.","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali H.","family":"Jafry","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Haris","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Nishtar Medical College  Multan Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-6351","authenticated-orcid":false,"given":"Muhammad Shahzeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine John H. 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