Arrhythmias & electrophysiologyMeta-analysis
Post-Catheter Ablation Long-Term Antithrombotic Strategies in Atrial Fibrillation: A Network Meta-Analysis of Randomized Controlled Trials
- network meta-analysis of randomized controlled trials
- systematic literature search
- frequentist network meta-analysis
- pooled incidence meta-analysis
Authors' conclusion
This analysis reinforces that, across randomized data, the incidence of thromboembolic events in patients who discontinued OAC after successful ablation remained low. However, the evaluation of net clinical benefit is limited by the low number of events across all treatment arms, underscoring the need for larger studies with prolonged follow-up to further validate the safety of this strategy, particularly in higher-risk populations.
Study context
- Population
- Patients with atrial fibrillation undergoing catheter ablation
- Participants
- 3,924 Four randomized controlled trials
- Comparison
- Oral anticoagulation (OAC) or left atrial appendage occlusion with no antithrombotic therapy
- Outcome
- Ischemic stroke
Pooled result
As reported in the abstract
- left atrial appendage occlusion
- incidence rate ratio 0.79 (95% CI 0.00–241.01); P = 0.94
Further pooled results
Pooled incidence of stroke among patients who discontinued antithrombotic therapy without undergoing left atrial appendage occlusion (n=1161) · 2864 cumulative person-years of follow-up
- Pooled incidence of stroke
- 0.23 events per 100 person-years (95% CI, 0.02-2.43)
- I 2
- 0%
Original publication
Summarised from the published abstract; every number is checked against it