{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:06:58Z","timestamp":1785546418853,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal long\u2010term antithrombotic strategy after apparently successful catheter ablation of atrial fibrillation (AF) remains uncertain, particularly in patients who meet conventional guideline thresholds for oral anticoagulation (OAC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare continuation versus cessation strategies of long\u2010term OAC after successful AF ablation and to quantify net clinical benefit (NCB) integrating thromboembolic and bleeding outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Cochrane CENTRAL, and Embase from inception through February 2026 for randomized and comparative observational studies evaluating long\u2010term OAC continuation versus cessation (no OAC and\/or switch to aspirin) after successful AF ablation. Risk of bias was assessed using RoB2 for randomized trials and a modified Newcastle\u2013Ottawa Scale (NOS) for observational studies. Random\u2010effects meta\u2010analyses used a restricted maximum likelihood estimator with Hartung\u2013Knapp adjustment. NCB was calculated as: thromboembolic event rate \u2212 (1.5 \u00d7 major bleeding rate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six studies met the inclusion criteria (four randomized trials and two observational cohorts). Stroke\/transient ischemic attack (TIA) events were reported in six studies and were not significantly different between OAC continuation and cessation strategies (OR 0.69; 95% CI 0.24\u20131.99;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.49). Systemic embolism (three studies) did not differ between groups (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.12). Major bleeding (five studies) was numerically higher with continued OAC but not statistically significant (OR 2.07; 95% CI 0.88\u20134.86;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.09). In NCB analysis, continued OAC yielded more negative or near\u2010neutral NCB values, whereas, the cessation strategies were less negative or marginally positive; the fixed\u2010effect risk difference in NCB (continued OAC vs cessation) was +0.00067 (95% CI \u22120.00279 to +0.00413).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta\u2010analysis suggests that after successful AF ablation, continuing OAC does not significantly reduce stroke risk compared to cessation or switching to aspirin, but it may increase major bleeding. While NCB trends favor cessation, the low absolute event rates and the risk of silent AF recurrence necessitate caution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70224","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:26:01Z","timestamp":1774589161000},"page":"590-601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy, Safety, and Net Clinical Benefit of Post\u2010Atrial Fibrillation Ablation Anticoagulation"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9939-7747","authenticated-orcid":false,"given":"Mustafa","family":"Abomohsen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Brookdale University Hospital  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1186-2595","authenticated-orcid":false,"given":"Ahmed Elmorsy","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Brookdale University Hospital  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Hakim","family":"Almakadma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Brookdale University Hospital  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azad","family":"Mojahedi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Brookdale University Hospital  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyad","family":"Kholeif","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Baptist Hospitals of Southeast Texas  Beaumont Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Elalfy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Shams","sequence":"additional","affiliation":[{"name":"Harvard Medical School Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5802-2291","authenticated-orcid":false,"given":"Ahmed Farid","family":"Gadelmawla","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Menoufia University  Menoufia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3778-1565","authenticated-orcid":false,"given":"Imad Samman","family":"Tahhan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Wellington Regional Medical Center  Wellington Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohab","family":"Elnashar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Rashwan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NYC Health and Hospitals\/Lincoln  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elnady","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kafrelsheikh University  Kafrelsheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Gunsburg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Brookdale University Hospital  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392\u2010023\u201002319\u20109"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14052"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_11_10_1","unstructured":"G.Wells B.Shea D.O'Connell et\u00a0al. \u201cThe Newcastle\u2013Ottawa Scale (NOS) for Assessing the Quality of 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