Oral Anticoagulation After Pulmonary Vein Isolation

Tuesday, December 20, 2016 11:03:00 AM

Do patients with atrial fibrillation and risk factors for stroke benefit from oral anticoagulation therapy after pulmonary vein isolation?  That is the question researchers studied, with results published in the November 23d issue of JAMA Cardiology 

This was a retrospective cohort study using Swedish national health registries.  A total of 1585 patients with a fib undergoing pulmonary vein isolation (PVI) were included.  The investigators looked at the incidence of ischemic stroke, intracranial hemorrhage, and death in patients with a CHA2DS2-VASc score of 2 or more and discontinuing anticoagulation treatment (with warfarin) after PVI.  The CHA2DS2-VASc score considers congestive heart failure, hypertension, age greater than or equal to 75 years, diabetes, stroke, vascular disease, age 65-74 years, and female gender.  They found that discontinuation of warfarin after PVI is not safe in high-risk patients, especially those who have previously experienced an ischemic stroke.  

What are your thoughts on this study?