{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:53:46Z","timestamp":1791356026575,"version":"4.3.1"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Despite the growing use of catheter ablation for atrial fibrillation, large\u2010scale studies assessing the efficacy and safety of oral anticoagulation (OAC) after ablation, particularly in patients with high stroke risk, remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This prospective study enrolled consecutive patients from the China\u2010AF (China Atrial Fibrillation) registry between August 2011 and June 2022. Stroke risk was stratified by CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VA score as low (0\u20131), intermediate (2), or high (\u22653). The study end points were thromboembolism (ischemic stroke or systemic embolism), and bleeding (International Society on Thrombosis and Hemostasis major bleeding and clinically relevant non\u2010major bleeding). A 6\u2010month landmark analysis was applied to evaluate the association of OAC with end points using incidence rates and Cox models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 13\u2009669 patients (median follow\u2010up, 4.0\u2009years), 2637 continued and 11\u2009032 discontinued OAC at the 6\u2010month landmark. OAC was not associated with reduced thromboembolism risk across low\u2010 (adjusted hazard ratio [aHR], 1.11 [95% CI, 0.70\u20131.77];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.649), intermediate\u2010 (aHR, 0.64 [95% CI, 0.36\u20131.16];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.141) or high\u2010stroke risk patients (aHR, 1.05 [95% CI, 0.74\u20131.48];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.801). In contrast, continued OAC was associated with higher bleeding risk, including clinically relevant non\u2010major bleeding across stroke risk strata, and International Society on Thrombosis and Hemostasis major bleeding among high\u2010risk patients (aHR, 2.32 [95% CI, 1.19\u20134.50];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.013). These results were consistent across subgroups and sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In this large, real\u2010world cohort of patients with atrial fibrillation undergoing catheter ablation, continued OAC was not associated with lower thromboembolic risk, but with higher major bleeding risk among patients with CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VA scores \u22653. These findings support individualized post\u2010ablation anticoagulation strategies and warrant future investigation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique Identifier: NCT06987825.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047527","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:24:13Z","timestamp":1788150253000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Thromboembolism and Bleeding 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