Some atrial fibrillation patients may stop blood thinners after ablation, study says

Patients in the study who had no atrial fibrillation recurrence after their last ablation were more likely to have stopped taking blood thinners, researchers report.

By Amy Wallace

March 17 (UPI) -- Researchers suggest certain patients with atrial fibrillation, or AF, can safely stop using blood thinner medication after undergoing catheter ablation.

AF is an irregular heartbeat that can lead to blood clots, stroke, heart failure and other cardiovascular conditions.


A team at the University of Pennsylvania School of Medicine shows that patients with persistent AF or those at high risk for recurring AF who undergo catheter ablation, a minimally-invasive procedure involving cauterization of areas of the heart that cause irregular heartbeats, may be able to safely stop taking blood thinners.

The standard protocol of many doctors is to have patients continue taking blood thinner medication even after successful catheter ablation procedure.

"There are two schools of thought when it comes to anticoagulant therapy following catheter ablation for the treatment of AF," Dr. Jackson J. Liang, a cardiovascular disease fellow in the Perelman School of Medicine at the University of Pennsylvania, said in a press release. "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."


To determine if anticoagulants are indeed necessary after successful ablation, researchers studied 400 participants over a three-year period who had persistent and longstanding persistent, uninterrupted AF lasting more than one year who underwent one or more ablation procedures.

Participants checked their pulse twice daily, had routine outpatient telemetry tests to evaluate asymptomatic AF and had electrocardiograms based on symptoms.

Researchers found 172 patients had no AF recurrence, 161 were transformed to paroxysmal or sudden AF, and 67 had persistent AF during the study period. Of the participants, 207 had discontinued the use of blood thinners during the study period and 174 remained off blood thinners at their last follow-up.

Patients who had no AF recurrence after their last ablation were more likely to have stopped taking blood thinners as compared to those whose AF was transformed to sudden AF or who remained persistent.

"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," Dr. David Callans, associate director of Electrophysiology for the University of Pennsylvania Health System, said.

The study was presented at the American College of Cardiology 66th Annual Scientific Session.


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