BACKGROUND: There is significant practice variation in oral anticoagulation (OAC) use following catheter ablation for @entity955 . It is not clear whether the risk of cardioembolism increases after discontinuation of OAC following catheter ablation. METHODS AND RESULTS: We identified 6886 @entity1 within a large national administrative claims database who underwent catheter ablation for @entity955 between January 1, 2005, and September 30, 2014. We assessed the effect of time off of OAC by CHA2DS2-VASc score (after adjusting for other comorbidities) on risk of cardioembolism, using Cox proportional hazards models. There was an increase in the use of non- @entity2067 OAC after ablation from 0% in 2005 to 69.8% in 2014. OAC discontinuation was high, with only 60.5% and 31.3% of @entity1 remaining on OAC at 3 and 12 months, respectively. The rate of discontinuation was higher in low-risk @entity1 (82% versus 62.5% at 12 months for CHA2DS2-VASc 0-1 versus >= 2, respectively; P<0.001). @entity64 occurred in 1.4% of @entity1 with CHA2DS2-VASc >= 2 and 0.3% of those with CHA2DS2-VASc 0 or 1 over the study follow-up. The risk of cardioembolism in the first 3 months after ablation was increased among those with any time off OAC (hazard ratio 8.06 [95% CI 1.53-42.3], P<0.05). The risk of cardioembolism beyond 3 months was increased with OAC discontinuation among high-risk @entity1 (hazard ratio 2.48 [95% CI 1.11-5.52], P<0.05) but not low-risk @entity1 . CONCLUSION: The overall risk of @entity64 in postablation @entity1 is low; however, OAC discontinuation after ablation is common and is associated with increased risk of cardioembolism for all @entity1 within the first 3 months and for high-risk @entity1 in the long term. Continuing OAC for at least 3 months in all @entity1 and indefinitely in high-risk @entity1 appears to be the safest strategy.

Patterns of Anticoagulation Use and Cardioembolic Risk After Catheter Ablation for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'Stroke'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K']
@entity955 :: (MESH:D001281,Disease) :: ['Atrial Fibrillation']
