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New research · Internal Medicine
Journal of the American Heart Association · 3h
Cohort studyJournal of the American Heart Association · 2026

Stopping Oral Anticoagulation After Catheter Ablation for Atrial Fibrillation in Patients With High Risk of Stroke: STOP-OAC Study.

Tetsuma Kawaji, Yoshimori An, Shushi Nishiwaki … Atsushi Kobori
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Internal MedicineCohort study

Stopping anticoagulation after atrial fibrillation ablation was associated with less bleeding, similar stroke risk

Stopping Oral Anticoagulation After Catheter Ablation for Atrial Fibrillation in Patients With High Risk of Stroke: STOP-OAC Study.

Tetsuma Kawaji … Atsushi Kobori
Journal of the American Heart Association · 2026
Background

The benefit of continuing oral anticoagulation (oral anticoagulation) after catheter ablation (catheter ablation) for atrial fibrillation (atrial fibrillation) in patients with a high risk of stroke remains unclear.

Purpose

The Safeness or Threat Of Pausing-Oral anticoagulant therapy After Catheter ablation for atrial fibrillation study (STOP-oral anticoagulation study) aimed to investigate the safety and efficacy of oral anticoagulation discontinuation after catheter ablation for atrial fibrillation in patients with CHADS 2 score ≥2.

Methods

We enrolled 1655 consecutive patients with atrial fibrillation with CHADS 2 score ≥2 (mean CHADS 2 of 2.4 and CHA 2 DS 2 -VASc of 3.8) who underwent first-time catheter ablation at 8 institutions in Japan from April 2021 to March 2024.

n = 1241 patients
Results

less major bleeding when anticoagulation was stopped

0.4% per
Off-OAC
1.7% per
On-OAC
More results

There were 327 patients who had stopped oral anticoagulation at 240 days (off-oral anticoagulation group), and 1241 patients who continued oral anticoagulation at 240 days (on-oral anticoagulation group).

More results

Patients in the off-oral anticoagulation group compared with those in the on-oral anticoagulation group less often had nonparoxysmal atrial fibrillation (43.1% and 54.3%), and history of ischemic stroke (7.7% and 23.4%) with lower CHADS 2 score (2.2±0.5 and 2.4±0.6).

“
Conclusion

The STOP-oral anticoagulation study provides real-world evidence supporting the safety and efficacy of early oral anticoagulation discontinuation after catheter ablation of atrial fibrillation in selected patients with CHADS 2 score ≥2.

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