Ons Marsit: What Is the Residual Thromboembolic Risk After AF Ablation?
Ons Marsit, Field Clinical Specialist at Boston Scientific, shared a post on LinkedIn about a recent article by Xiaodong Peng et al., published in EP Europace, adding:
”What is the residual thromboembolic risk after AF ablation?
A new EP Europace study used a target trial emulation to evaluate OAC discontinuation vs continuation in 8,339 patients after AF ablation.
Patients had CHA₂DS₂-VA greater than or equal to 2, no prior thromboembolism, and no documented atrial arrhythmia recurrence during the first 6 months after ablation.
Main findings
- No significant difference in the composite of stroke/systemic embolism and major bleeding: HR 0.93 (95 percent CI 0.67–1.29)
- No significant difference in thromboembolic events: HR 0.96 (95 percent CI 0.69–1.35)
- Clinically relevant non-major bleeding was lower after OAC discontinuation: HR 0.68 (95 percent CI 0.47–0.97)
Residual thromboembolic risk after OAC discontinuation according to CHA₂DS₂-VA:
- Score 2 to 0.64percent/year
- Score 3 to 0.86 percent/year
- Score greater than or equal to 4 to 1.52percent/year
The study highlights the importance of residual thromboembolic risk stratification after AF ablation, even among patients without documented recurrence during the first 6 months.
Rhythm surveillance was based on periodic Holter monitoring and symptom-driven ECG rather than continuous monitoring, so asymptomatic recurrences may have been missed.”
Title:Residual thromboembolic risk and outcomes of oral anticoagulation discontinuation after atrial fibrillation ablation: a target trial emulation
Authors: Xiaodong Peng, Liu He, Jue Wang, Sitong Li, Qifan Li, Zixu Zhao, Zejun Yang, Mingxiao Li, Fadong Li, Xiaoxia Liu, Song Zuo, Xueyuan Guo, Junmeng Zhang, Ning Zhou, Yunlong Wang, Deyong Long, Caihua Sang, Xin Du, Jianzeng Dong, Changsheng Ma
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