Arrhythmias & electrophysiologyRandomised controlled trial
Cognitive function and anticoagulation discontinuation in patients without long-term recurrence after catheter ablation for atrial fibrillation: A substudy of the ALONE-AF trial
- randomized trial
- substudy of the ALONE-AF trial
- randomized in a 1:1 ratio
Authors' conclusion
Among patients without AF recurrence for at least 12 months after ablation, OAC discontinuation may not be associated with cognitive decline. Findings should be interpreted cautiously, as the study was not designed to evaluate this association.
Study context
- Population
- Patients with atrial fibrillation (AF) aged 19–80 years without atrial arrhythmia recurrence ≥12 months after ablation and with at least 1 non-sex-related stroke risk factor (CHA2DS2-VASc score), who completed the Montreal Cognitive Assessment (MoCA) at baseline and 2-year follow-upsubset who completed the MoCA at baseline and the 2-year follow-up · no-OAC 318 · oral anticoagulant (OAC) 328
- Participants
- 318 vs 328
- Comparison
- discontinue or continue OAC therapy
- no-OACn = 318
- OACn = 328
Primary result
Total MoCA score change · 2-year follow-up
Between-group difference in change
0.1
95% CI −0.3 to 0.5
P = 0.759
By group
no-OAC
0.6
difference (24.4 to 25.0) · 95% CI 0.3–0.9
OAC
0.7
difference (24.2 to 24.9) · 95% CI 0.4–1.0
no-OAC vs OAC
between-group difference in change 0.1 (95% CI −0.3 to 0.5); P = 0.759
As reported in the abstract
Further findings
MoCA domains · 2-year follow-up
- No difference between no-OAC and OAC groups in any MoCA domains
Baseline characteristics
- Mean age
- 63.9 years
- Women
- 25.9%
- Median (interquartile range) CHA2DS2-VASc score
- 2 (1-3)
Original publication
Cognitive function and anticoagulation discontinuation in patients without long-term recurrence after catheter ablation for atrial fibrillation: A substudy of the ALONE-AF trial. Heart Rhythm. Published 24 April 2026. doi:10.1016/j.hrthm.2026.04.023
Summarised from the published abstract; every number is checked against it