Arrhythmias & electrophysiologyMeta-analysis
Clinical outcomes of continuing vs. discontinuing oral anticoagulation after atrial fibrillation ablation: an updated systematic review and meta-analysis of observational studies and randomized controlled trials
- Systematic review and meta-analysis of observational studies and randomised controlled trials
Authors' conclusion
In patients with CHA2DS2-VASc scores ≥2, particularly when baseline risk is well-balanced between groups, continuation of OAC after AF ablation is associated with a significantly lower risk of stroke/TIA.
Study context
- Population
- Patients after successful atrial fibrillation (AF) catheter ablation
- Comparison
- Continuing vs discontinuing oral anticoagulation (OAC) after AF ablation
- Outcome
- Stroke/TIA
Pooled result
As reported in the abstract
Odds ratio
1.48
95% CI 0.84–2.60
P = 0.16
OAC continuation vs OAC discontinuation
OR 1.48 (95% CI 0.84–2.60); P = 0.16
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Stroke/TIA, CHA2DS2-VASc ≥2 (subgroup) | 0.42 (0.18–0.95) | P = 0.04 | |
| Stroke/TIA, studies with well-balanced baseline risk (subgroup) | 0.50 (0.34–0.72) | P < 0.01 | |
| 0.20.5125Odds ratio (log scale) |
MACE, all-cause mortality
- No significant association for MACE or all-cause mortality
Safety
Major bleeding
- OAC continuation significantly increased the risk of major bleeding
Original publication
Clinical outcomes of continuing vs. discontinuing oral anticoagulation after atrial fibrillation ablation: an updated systematic review and meta-analysis of observational studies and randomized controlled trials. Europace. Published 8 July 2026. doi:10.1093/europace/euag104
Summarised from the published abstract; every number is checked against it