CLINICAL
NEWS
American College of Cardiology Extended Learning
After AF Ablation, Keep Patients
on Warfarin Until …
O
ver the past decade, catheter ablation has
emerged as a potential cure for AF, although
sometimes the procedure needs to be performed multiple times for long-term effectiveness.
One of the most important questions related to
this therapy remains unanswered: does long-term
maintenance of SR after successful catheter ablation eliminate stroke risk in patients with AF, thus
permitting discontinuation of oral anticoagulation
therapy (OAT)?
Without a well-studied answer to that question,
two recent expert consensus documents recommend
continuing OAT indefinitely, at least in patients at high
risk of thromboembolic events (TE).1,2 Nevertheless, it
remains controversial and some centers implement a
policy of withdrawing OAT even in the majority of patients at high risk of TE (17% of 42 centers worldwide
surveyed in a recent questionnaire).
BEST DATA TO DATE, BUT…
Themistoclakis and colleagues reported an evaluation
of 3,355 patient records from five well-known AF
ablation centers.3 In 2,692 patients (~80%), OAT was
discontinued 3