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Discontinuing Warfarin After AF Ablation in Patients with CHADS Score ≥ 2
고려대학교 안암병원
Daniel Tanubudi, Yasutsugu Nagamoto, Ko Yiu Kwan, 반지은, 박재석, 최종일, 박상원, 김영훈
Background The recently published HRS/EHRA/ECAS atrial fibrillation (AF) Ablation Consensus Statement did not recommend discontinuity of warfarin therapy post AF ablation in patients with CHADS score ≥ 2. The objective of this study was to retrospectively assess the outcome of the patients with CHADS score ≥ 2 after AF ablation. Method A total of 39 patients (10.1%) with CHADS score≥ 2 from 385 patients who underwent AF ablation in period of 2008 – mid 2010 were retrospectively studied regarding AF recurrence rate, antiarrhythmic drug (AAD) use, warfarin use, and the incidence of stroke after AF ablation. Result Of 39 patients, paroxysmal AF (PAF) was 24 and persistent AF was 15. History of stroke before ablation was observed in 20 patients (51.2%). From this group of patients, we found only 6 (16.6%) experienced AF recurred. AAD and warfarin was discontinued in 28 (71.8%), and 25 (64.2%) patients, respectively. Aspirin, clopidogrel and ticlopidine were used after discontinuing warfarin in 11 (28.2%), 14 (35.8%), and 2 (5%), respectively. One patient (2.5%) used both aspirin and clopidogrel, and another 1 patient used warfarin and clopidogrel. Only 1 (2.5%) patient experienced cerebral hemorrhage during follow up of 9.2 ± 5.7 months. Conclusion We found that discontinuing warfarin after AF ablation in patients with CHADS score ≥ 2 who maintained sinus rhythm, was not related to any thromboembolic complications. Further prospective randomized study by comparing with CHADS score < 2 group is warranted.


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