{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:24:45Z","timestamp":1792686285957,"version":"4.5.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,29]]},"abstract":"\n Background<\/jats:title>\n \n There is significant practice variation in oral anticoagulation (\n OAC<\/jats:styled-content>\n ) use following catheter ablation for atrial fibrillation. It is not clear whether the risk of cardioembolism increases after discontinuation of\n OAC<\/jats:styled-content>\n following catheter ablation.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We identified 6886 patients within a large national administrative claims database who underwent catheter ablation for atrial fibrillation between January 1, 2005, and September 30, 2014. We assessed the effect of time off of\n OAC<\/jats:styled-content>\n by\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score (after adjusting for other comorbidities) on risk of cardioembolism, using Cox proportional hazards models. There was an increase in the use of non\u2013vitamin K\n OAC<\/jats:styled-content>\n after ablation from 0% in 2005 to 69.8% in 2014.\n OAC<\/jats:styled-content>\n discontinuation was high, with only 60.5% and 31.3% of patients remaining on\n OAC<\/jats:styled-content>\n at 3 and 12\u00a0months, respectively. The rate of discontinuation was higher in low\u2010risk patients (82% versus 62.5% at 12\u00a0months for\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c 0\u20131 versus \u22652, respectively;\n P<\/jats:italic>\n <0.001). Stroke occurred in 1.4% of patients with\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c \u22652 and 0.3% of those with\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c 0 or 1 over the study follow\u2010up. The risk of cardioembolism in the first 3\u00a0months after ablation was increased among those with any time off\n OAC<\/jats:styled-content>\n (hazard ratio 8.06 [95%\n CI<\/jats:styled-content>\n 1.53\u201342.3],\n P<\/jats:italic>\n <0.05). The risk of cardioembolism beyond 3\u00a0months was increased with\n OAC<\/jats:styled-content>\n discontinuation among high\u2010risk patients (hazard ratio 2.48 [95%\n CI<\/jats:styled-content>\n 1.11\u20135.52],\n P<\/jats:italic>\n <0.05) but not low\u2010risk patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The overall risk of stroke in postablation patients is low; however,\n OAC<\/jats:styled-content>\n discontinuation after ablation is common and is associated with increased risk of cardioembolism for all patients within the first 3\u00a0months and for high\u2010risk patients in the long\u00a0term. Continuing\n OAC<\/jats:styled-content>\n for at least 3\u00a0months in all patients and indefinitely in high\u2010risk patients appears to be the safest strategy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002597","type":"journal-article","created":{"date-parts":[[2015,11,6]],"date-time":"2015-11-06T03:18:53Z","timestamp":1446779933000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":80,"title":["Patterns of Anticoagulation Use and Cardioembolic Risk After Catheter Ablation for Atrial Fibrillation"],"prefix":"10.1161","volume":"4","author":[{"given":"Peter A.","family":"Noseworthy","sequence":"first","affiliation":[{"name":"Heart Rhythm Section, Cardiovascular Diseases, Mayo Clinic, Rochester, MN"},{"name":"Robert D. and Patricia E. 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