Stopping oral anticoagulation therapy after successful atrial fibrillation ablation may lower risk of harm

Medical Xpress / European Society of Cardiology / JAMA ^ | Sept. 1, 2025 | Daehoon Kim et al

[ConservativeMind]

Discontinuing oral anticoagulation (OAC) therapy resulted in a lower risk of a composite of stroke, systemic embolism or major bleeding than continuing OAC therapy in patients who had successful ablation for atrial fibrillation at least 12 months previously, according to results from a late-breaking trial.

Atrial fibrillation (AF) is a common type of arrhythmia characterized by an abnormal irregular heartbeat that can increase the risk of stroke and thromboembolism (blood clots). Ablation can be used to destroy small sections of heart tissue that may be causing abnormal heartbeats.

Oral anticoagulation (OAC) is recommended in all patients for at least two months after AF ablation to reduce the risk of stroke or thromboembolism. Thereafter, guidelines recommend continuing OAC depending on the patient's risk of stroke.

The ALONE-AF trial was an open-label randomized superiority trial conducted at 18 sites in South Korea.

Patients were randomized 1:1 to receive direct OAC or no OAC therapy.

The study population included 840 randomized patients who had a mean age of 64 years, with one-quarter (25%) being women.

At 24 months, OAC was associated with a higher risk of net adverse clinical events than no OAC (2.2% vs. 0.3%; absolute difference −1.9%).

No significant difference was observed in the incidence of ischemic stroke or systemic embolism at 24 months between the OAC and no-OAC groups (0.8% vs. 0.3%, respectively; absolute difference −0.5%). Major bleeding occurred in 1.4% of patients in the OAC group and 0% in the no-OAC group (absolute difference –1.4%.)

Concluding, Professor Joung said, "In the first randomized trial to address this question, receiving no OAC treatment resulted in a lower risk of harmful events than OAC treatment.

"Our findings indicate that lifelong OAC might not be necessary in all patients who have had successful AF ablation at least one year previously."

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TOPICS: Health/Medicine
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[ConservativeMind]

It appears anticoagulation medicines are hurtful beyond the 12 month point, post atrial fibrillation ablation.

[ConservativeMind]

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[E. Pluribus Unum]

Before you have ablation for AFIB, you should try taking a potassium supplement first. That AFIB is probably because of an electrolyte imbalance. Problem is, there is not money in potassium supplementation. Ablation is a lot more lucrative.

[oldplayer]

Successful ablation 10 years ago. No blood thinners after 8 months other than a baby aspirin. No reocurrence of A-fib. I ran 5 miles Sunday morning. Bicycled 75 miles last Sunday, 25 tonight. I’m not very fast anymore, but have good endurance and no A-fib. Some things in medical science are amazing.

[for-q-clinton]

That title reads like a joke though.

[jimfr]

what is your age?
I needed a second ablation a year after the first. Blood thinner was stopped immediately after the ablation. Potassium did not help. Able to walk a mile at a fast rate, paddle for an hour, but get lightheaded if I straighten up fast from bending over. Other than that have had no problems since the ablation. I am 68. I consider that a success from having
Afib being trigger from events of vomiting, bowel movements, hip cupping and even laying down for the night.