Electrophysiology Service, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA.
Electrophysiology Section, Division of Cardiology, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
Curr Cardiol Rep. 2020 Jun 19;22(8):58. doi: 10.1007/s11886-020-01313-1.
This review discusses the pros and cons of discontinuing oral anticoagulation therapy (OAT) after catheter ablation of atrial fibrillation (AF), and data from relevant studies, and summarizes the most recent Expert Consensus recommendations on the topic.
Patients with AF are at risk of cerebrovascular embolic events (CVEs) including stroke and transient ischemic attacks. OAT can be effective in preventing CVEs, while catheter ablation is an effective treatment to eliminate AF. Whether OAT can be safely discontinued after successful AF ablation remains a controversial topic. Retrospective studies have suggested that successful AF ablation may mitigate the risk of CVE such that OAT may be discontinued in select patients after AF ablation. In certain patients with AF who undergo successful AF ablation, OAT might be able to be safely discontinued with continued long-term rhythm monitoring.
本篇综述讨论了在房颤（AF）导管消融术后停止口服抗凝治疗（OAT）的利弊，以及相关研究的数据，并总结了该主题的最新专家共识建议。
AF 患者有发生脑血管栓塞事件（CVE）的风险，包括中风和短暂性脑缺血发作。OAT 可有效预防 CVE，而导管消融是消除 AF 的有效治疗方法。AF 消融成功后是否可以安全地停止 OAT 仍然是一个有争议的话题。回顾性研究表明，AF 消融成功可能会降低 CVE 的风险，因此在某些 AF 消融成功的患者中可以停止 OAT。对于某些接受成功 AF 消融的 AF 患者，在继续进行长期节律监测的情况下，OAT 可能可以安全地停止。
