For patients with persistent AF or those who are at high risk for recurring AF, catheter ablation—a minimally invasive procedure in which the areas of the heart causing the irregularity are cauterized—is recommended, followed most often by continued use of blood thinners, regardless of whether the ablation procedure was effective.
In new study presented today at the American College of Cardiology 66th Annual Scientific Session, researchers from the Perelman School of Medicine at the University of Pennsylvania have found that patients with persistent AF, who are successfully treated with ablation many, in fact, no longer need blood thinners.
"Those who think all patients with AF should be prescribed blood thinners based on stroke risk scores even after their AF has been 'cured' by successful ablation, and those who believe that if there is no evidence of AF recurrence following ablation, then anticoagulants may be unnecessary." In this retrospective study, researchers evaluated 400 participants with persistent and longstanding persistent - uninterrupted AF lasting more than1 year - who underwent one or more ablations, to determine the patterns of anticoagulation use after ablation based on AF recurrences, as well as likelihood of developing stroke or major bleeds after the procedure.
"This data shows that in certain patients with nonparoxysmal AF who no longer have recurring AF following catheter ablation as confirmed by routine monitoring and daily pulse checks, anticoagulation may be safely discontinued to minimize the risk for major bleeding," said the study's senior author, David Callans, MD, the associate director of Electrophysiology for the University of Pennsylvania Health System.
Patients with recurring AF or those who are high risk for persistent AF are subsequently at higher risk for cerebrovascular such as stroke or transient ischemic attack (mini stroke).