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July 22, 2026TH OpenOpen Access

Antithrombotic Management After Successful Catheter Ablation for Atrial Fibrillation: Meta-Analysis of the ALONE-AF and OCEAN Trials

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Why the study?

Does DOAC discontinuation reduce bleeding without increasing thromboembolic events in patients with no documented AF recurrence for ≥1 year after catheter ablation?

Population

2124 patients with no documented atrial fibrillation recurrence for ≥1 year after catheter ablation

Comparison

Direct oral anticoagulant (DOAC) discontinuation vs Direct oral anticoagulant (DOAC) continuation

Design

Meta-analysis

Key result

The provided text consists solely of an editorial board list and contains no clinical trial results or findings.

Authors

WCW ChengYCYi‐Hsin ChanLKLing Kuo

Discussion

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Overview

Supports DOAC discontinuation after successful AF ablation to reduce bleeding; extends RCT evidence with no rise in thromboembolic events.

Key Points

  • This study aimed to compare long-term antithrombotic strategies in patients without atrial fibrillation recurrence after catheter ablation.
  • Conducted a meta-analysis of the ALONE-AF and OCEAN trials involving 2124 patients.
  • Compared outcomes of direct oral anticoagulant (DOAC) continuation versus discontinuation.
  • Calculated pooled risk ratios for thromboembolic events, mortality, and bleeding events.
  • No statistically significant difference in thromboembolic events or mortality rates between DOAC continuation and discontinuation.
  • DOAC continuation linked to a higher risk of major bleeding (RR 3.07; 95% CI: 1.05-8.96).
  • DOAC discontinuation lowered the risk of bleeding without increasing stroke risk.

Study Design

Type

Meta-Analysis

Structured PICO

Does DOAC discontinuation reduce bleeding without increasing thromboembolic events in patients with no documented AF recurrence for ≥1 year after catheter ablation?

P
Population
2124 patients with no documented atrial fibrillation recurrence for ≥1 year after catheter ablation (pooled from ALONE-AF and OCEAN trials)
I
Intervention
Direct oral anticoagulant (DOAC) discontinuation
C
Comparator
Direct oral anticoagulant (DOAC) continuation
O
Outcome
Primary efficacy (thromboembolic events/all-cause mortality) and safety (bleeding events)composite

Discontinuing DOACs in patients free from AF for at least one year post-ablation significantly reduces bleeding risk without increasing thromboembolic events.

Cite This Study

Cheng et al. (2026) conducted a meta-analysis in Atrial Fibrillation. Antithrombotic Management was evaluated. The provided text consists solely of an editorial board list and contains no clinical trial results or findings.

synapsesocial.com/papers/6a605ea14163e025518d8654https://doi.org/10.1055/a-2916-8912
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