The Lead Episode 132: A Discussion of Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation (English Language Episode)-The Lead Episode 132 Bonus Video File

Video Transcription

Video Summary

In this LEAD Podcast episode, experts discuss the OCEAN trial on stopping oral anticoagulation after successful atrial fibrillation (AF) catheter ablation. The study randomized low-risk patients (mean CHA2DS2-VASc ~2) who were AF-free at one year into rivaroxaban or low-dose aspirin groups. Over three years, stroke/embolism rates were very low in both groups (0.8% rivaroxaban vs. 1.4% aspirin), with no significant difference in major bleeding. The trial stopped early due to low event rates, suggesting oral anticoagulation may be safely discontinued in select low-risk, well-monitored patients post-ablation. Limitations included reliance on intermittent Holter monitoring rather than continuous implantable devices. The experts highlighted evolving evidence and approaches, emphasizing individual risk assessment and potential for guideline changes. Overall, in low-risk AF patients successfully ablated and carefully followed, stopping anticoagulants after one year may be reasonable, balancing stroke prevention against bleeding risk.

Keywords

OCEAN trial

atrial fibrillation

oral anticoagulation cessation

catheter ablation

stroke prevention