Aspirin may be Better than Anticoagulation post ablation—New Study

Conclusion: Among patients who had had successful catheter ablation for atrial fibrillation at least 1 year earlier and had risk factors for stroke, treatment with rivaroxaban did not result in a significantly lower incidence of a composite of stroke, systemic embolism, or new covert embolic stroke than treatment with aspirin.

[www.nejm.org]

On a personal note, my EP talked me out of going back on anticoagulation recently, citing a study he would not name, because it had not yet been published. Pretty certain this was the one.

Jim



Edited 2 time(s). Last edit at 11/12/2025 02:34PM by mjamesone.

I was advised to just take baby aspirin a few times a week. I had the atri clip closure almost 20 years ago and still closed with no leaks. My EP told me that if I wanted to take a low dose Eliquis, he was ok with that, but why would I want to take a medication if not needed? I know folks who have the watchman and still on blood thinners. what was the point of getting that done if you still need to take that medication?

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sldabrowski
I know folks who have the watchman and still on blood thinners. what was the point of getting that done if you still need to take that medication?

I don't need to; I choose to.

I take a half-dose Eliquis because I'm a CHADS-Vasc 3 and not all strokes and systemic embolisms originate in the LAA. Also, blood clots aren't the only things that cause strokes. Ruptured plaques can do the same. If I need to stop for some reason, I just stop. I don't need any special procedures or precautions. In fact, I stopped for a full 4 months earlier this year because I was taking a prescription strength NSAID.

I don't find that study all that compelling, actually. Stroke prevention was slightly better with rivaroxaban, and bleed risk was only slightly worse. Also, noted that it was funded by Bayer. I read it as a "needs further study" kind of result. I'd like to see it replicated using apixaban instead of rivaroxaban.

It does come down to personal choice. Have you had a CIMT scan to see if you have plaque? Not a calcium score test. That does not tell you if the plaque you have is the soft kind. I get one every year and feedback is whatever little plaque I have is entheogenic. That helped me with my decision when discussed with the EP.

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sldabrowski
It does come down to personal choice. Have you had a CIMT scan to see if you have plaque?

No, but I know I have plaque because in 2017 Natale did a TEE that revealed "mild aortic plaque."

You lost me with the word "entheogenic." That word refers to psychoactive drugs.

Sorry, calcified plaque. This video by Dr. Brewer explains better than I can. He was my Doctor for several years before retiring. BTW. He has AFIB and diabetes. He is no stranger to cardio challenges.

[www.bing.com]