No antiarrhythmic effect of direct oral anticoagulants versus vitamin K antagonists in paroxysmal atrial fibrillation patients undergoing catheter ablation

David Zweiker*, Martin Manninger, Raphael Sieghartsleitner, Jakob Ebner, Bernadette Pratl, Egbert Bisping, Peter Lercher, Dirk von Lewinski, Rita Riedlbauer, Ursula Rohrer, Henri M H Spronk, Andreas Zirlik, Ulrich Schotten, Daniel Scherr

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review


INTRODUCTION: Direct oral anticoagulants (DOACs) are superior to vitamin K antagonists (VKAs) for the prevention of stroke in atrial fibrillation (AF) patients with elevated stroke risk. Possible antiarrhythmic effects of DOACs have been discussed. We analyzed impact of DOAC treatment on recurrence-free survival after AF catheter ablation.

METHODS: Two-hundred and thirty-nine consecutive patients (median age 57 [IQR 48-64] years, 26.4% female) undergoing ablation for paroxysmal AF were included into this study. 68.6% of them received DOACs (DOAC group), 31.4% VKA (VKA group). The primary outcome was arrhythmia-free one-year survival.

RESULTS: DOAC patients had lower BMI, shorter history of AF, less arterial hypertension, less vascular disease, less use of antiarrhythmics and consequently lower CHA2DS2-VASc and HAS-BLED Scores. There was no difference in arrhythmia-free survival between DOAC and VKA groups (DOAC: 86.6%, VKA: 76.7%, p = 0.286).

CONCLUSIONS: Despite baseline characteristics favouring a better outcome of DOAC patients, arrhythmia-free survival was similar in both groups. Consequently, DOAC treatment did not have clinically relevant antiarrhythmic properties in these patients.

Original languageEnglish
Pages (from-to)106-108
Number of pages3
JournalInternational Journal of Cardiology
Publication statusPublished - 15 May 2021


  • Administration, Oral
  • Anticoagulants/therapeutic use
  • Atrial Fibrillation/diagnosis
  • Catheter Ablation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Stroke/drug therapy
  • Vitamin K/therapeutic use
  • Catheter ablation
  • Atrial fibrillation
  • Anticoagulation
  • Vitamin K antagonist
  • Direct oral anticoagulants

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