Results:
A total of 106 patients underwent AFl ablation during the study period
(mean age 64±14; 78.3% male). Mean
CHA2DS2VaSC score was 3±1. OAC (warfarin
42.5%) was continued for at least 4 weeks post CA in all patients. OAC
was discontinued by 6 weeks in 17% of patients and by 1 year in 55.7%
(Figure 1A ). OAC was continued indefinitely in 44.3%. Most
common reasons for continued OAC included history of AF, new onset AF on
follow up or other non-arrhythmic indications for OAC. Over a mean
follow up of 28.6±27.3 months, 2.8% of patients developed AFl
recurrence and 33% developed AF. The median time to AF occurrence was
7.4 months (interquartile range, 0.9-24.4). During the study period, one
patient (CHA2DS2VaSC 2) in the OAC
discontinuation group developed a stroke 32 months after CA. There was
no AF detected and the stroke was atherosclerotic by imaging. There were
no thromboembolic events in the OAC continuation group. There were 3
major bleeding events in the OAC continuation group compared to none in
whom OAC was discontinued (p<0.001). All bleeding events were
gastrointestinal that required either an endoscopy and/or blood
transfusion. In the OAC discontinuation group, 12 (20.3%) patients
developed AF during follow up. Mean time to occurrence of AF was 30.2±26
months (Figure 1B ). Mean
CHA2DS2VaSC score of these patients was
2.6±1.7. Nine patients were restarted on OAC with mean duration of
30.1±24.6 months between OAC discontinuation and restarting.