The Long-Term Safety of Anticoagulation Strategy after Radiofrequency Catheter Ablation of Atrial Fibrillation

Background: The purpose of this study was to investigate the safety and efficacy of standard anticoagulation (SA) over 3 months after radiofrequency Catheter ablation (RFCA) of atrial fibrillation (AF) in comparison with the early-stopped warfarinization (EW) within 3 months. Methods and Results: We compared safety between SA (n=50) and EW (n = 59) group in 109 patients who underwent RFCA of AF (78 males, 55.9 ± 11 years old, paroxysmal AF 59.6%, CHADS2 score 1.5 ± 0.9, duration of follow up 693.1 ± 234.6 days, duration of AF 46.7 ± 42.5 months) There was no significant difference in CHADS2 score (1.5 ± 0.9 vs 1.4 ± 0.8, P = NS) between SA and EW group. Compared to EW group, uninterrupted preprocedural warfarinization (70.6% vs 39.4%, P = 0.014) was greater in SA group, therefore, INR value (1.47 ± 0.51 vs 1.14 ± 0.28, P = 0.002) at the procedure was higher. However, the incidence of hemorrhagic complications (11.9% vs 6.0%, P = NS) or the thromboembolic events (1.7% vs 0.0%, P = NS) was not different between two groups. Conclusion: In patients with low to intermediate risk of thromboembolism (mean CHADS2 1.5) early stopped warfarinization within 3 months after Catheter ablation of AF had comparable safety with warfarinization over 3 months. Further prospective study in large scale is warranted to determine long-term safety of each anticoagulation strategy.