loading page

Assessment of Thromboembolic Risk of Cessation of Oral Anticoagulation Post Catheter Ablation in Patients with and without Atrial Fibrillation Recurrence
  • +7
  • Bing Rong,
  • Wenqiang Han,
  • Mingjie Lin,
  • Li Hao,
  • Kai Zhang,
  • Tongshuai Chen,
  • Rina Sha,
  • Juntao Wang,
  • Rong Wang,
  • Jingquan Zhong
Bing Rong
Shandong University Qilu Hospital

Corresponding Author:rongbinger@126.com

Author Profile
Wenqiang Han
Shandong University Qilu Hospital
Author Profile
Mingjie Lin
Shandong University Qilu Hospital
Author Profile
Li Hao
Shandong Qianfoshan Hospital
Author Profile
Kai Zhang
Shandong University Qilu Hospital
Author Profile
Tongshuai Chen
Shandong University Qilu Hospital
Author Profile
Rina Sha
Shandong University Qilu Hospital
Author Profile
Juntao Wang
Shandong University Qilu Hospital
Author Profile
Rong Wang
Shandong University Qilu Hospital
Author Profile
Jingquan Zhong
Shandong University Qilu Hospital
Author Profile

Abstract

Instruction Cessation of oral anticoagulation (OAC) is common after the first 3 months of catheter ablation of atrial fibrillation (AF); however, thromboembolic risk has not been defined in patients with and without AF recurrence (RAF vs. NRAF) post ablation
Methods and Results We identified 796 patients who discontinued OAC at 3 months post AF ablation from January 2015 to May 2018 in our center. Regular follow-up was performed to detect RAF, collect medication management and thromboembolic and major bleeding events. CHA2DS2-VASc score was 1.79±1.50; 547 (68.7%) patients were at intermediate and high risk (i.e. CHA2DS2-VASc score ³1 in male patients, or ³2 in female patients); 169 (21.2%) were RAF. During 29.2±12.2 months follow-up, the incidence rate of thromboembolism was 1.62 per 100 patient-year (7 in 431 years) in RAF, 0.33 per 100 patient-year (5 in 1503 years) in NRAF. After adjusting for potential confounding factors, RAF was associated with more 3.5-fold higher rate of thromboembolism compared with NRAF (adjusting HR, 4.488; 95%CI, 1.381-14.586). Rate of thromboembolism was even higher in patients with intermediate and high risk (2.16 per 100 patient-year [7 in 323 years] versus 0.38 per 100 patient-year [4 in 1043 years], aHR, 5.807; 95%CI, 1.631-20.671). In multivariate logistic regression analysis, RAF was the only independent predictor of thromboembolism (4.837 [1.498-15.621], P=0.008).
Sep 2020Published in The American Journal of Cardiology. 10.1016/j.amjcard.2020.09.036