Arrhythmias & electrophysiologyRandomised controlled trial
Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation
- Randomised controlled trial
- multicentre
Authors' conclusion
Among patients without documented atrial arrhythmia recurrence after catheter ablation for AF, discontinuing oral anticoagulant therapy resulted in a lower risk for the composite outcome of stroke, systemic embolism, and major bleeding vs continuing direct oral anticoagulant therapy.
Study context
- Population
- Adults (19–80 years) with ≥1 non-sex-related stroke risk factor (CHA2DS2-VASc) and no documented atrial arrhythmia recurrence for ≥1 year after catheter ablation for atrial fibrillation (AF); 18 hospitals in South Korea
- Participants
- 840 adults
- Comparison
- Discontinuing vs continuing OAC after AF ablation
- Discontinue oral anticoagulant therapyn = 417
- Continue oral anticoagulant therapyn = 423reference
- Primary endpoint
- First occurrence of composite of:
- Stroke
- Systemic embolism
- Major bleeding
- Follow-up
- 2 years
Primary result
As reported in the abstract
Absolute difference
−1.9 percentage points
95% CI −3.5 to −0.3
P = 0.02
Events by treatment group
Discontinue OAC vs Continue OAC
absolute difference −1.9 percentage points (95% CI −3.5 to −0.3); P = 0.02
Secondary outcomes
| Outcome | Discontinue OAC | Continue OAC | absolute difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Ischemic stroke (2-year cumulative incidence) | 0.3% | 0.8% | −0.5 (−1.6 to 0.6) | |
| −2−101Difference, percentage points (linear scale) |
Safety
| Outcome | Discontinue OAC | Continue OAC | absolute difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Major bleeding | 0 events | 1.4% | −1.4 (−2.6 to −0.2) | |
| −4−202Difference, percentage points (linear scale) |
Original publication
Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation. JAMA. Published 14 October 2025. doi:10.1001/jama.2025.14679
Summarised from the published abstract; every number is checked against it