The app for independent voices
Stopping anticoagulants after successful Afib ablation.
I loved this study!
If you’ve had an ablation for atrial fibrillation and were told your rhythm is “fixed,” can you stop anticoagulation?
A study looked at this exact question. I have no affiliation to this article or study - I'm a private practice physician and just sharing the importance of this study for my own patients and perhaps yourself.
ALONE-AF was a randomized trial in patients who had no documented atrial arrhythmia recurrence for at least 12 months after AF ablation and had at least 1 non–sex-related stroke risk factor.
They compared discontinuing OAC vs continuing OAC and found:
Primary composite outcome (stroke, systemic embolism, or major bleeding) was lower with discontinuation: 0.3% vs 2.2%, mainly because there were fewer major bleeding events in the discontinuation group.
Ischemic events were rare in both groups, and differences in stroke/systemic embolism were not statistically significant in the trial reporting.
Top 3 questions I'd want my patients to ask me:
“Am I truly low enough risk to consider stopping my blood thinner?”
“How certain are we that my AFib has not come back?”
“What is my bleeding risk if I stay on anticoagulation?”