What is the recommended anticoagulation strategy for patients with AF and stable coronary artery disease undergoing catheter or surgical ablation?
For patients with AF and stable coronary artery disease undergoing catheter or surgical ablation, it is recommended to use uninterrupted anticoagulation with either an NOAC or adjusted-dose VKA therapy alone (target international normalized ratio [INR] range, 2.0-3.0) rather than combination of OAC and aspirin, based on randomized trials which have shown that uninterrupted warfarin is safe and superior to warfarin interruption for implantation of cardiac implantable electronic devices, and that uninterrupted rivaroxaban and dabigatran have been associated with fewer bleeding complications than uninterrupted warfarin. Additionally, discontinuation of OAC is associated with an increased risk of stroke after catheter ablation. 