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Stop Anticoagulation after Afib Ablation?

Anticoagulation After AF Ablation

Calculates CHA₂DS₂-VASc and HAS-BLED, then applies post-ablation clinical factors to guide continuation, possible discontinuation, or consideration of left atrial appendage closure.

Patient and ablation information

Age

Sex

Months since AF ablation

Post-ablation rhythm monitoring

CHA₂DS₂-VASc factors

Heart failure or LVEF ≤40% Hypertension Diabetes mellitus Prior stroke, TIA or systemic embolism Vascular disease: prior MI, PAD or aortic plaque

HAS-BLED factors

Uncontrolled hypertension, SBP >160 mmHg Abnormal renal function Abnormal liver function Prior major bleeding or bleeding predisposition Labile INR if treated with warfarin Concomitant antiplatelet therapy or chronic NSAID use Alcohol excess

Post-ablation risk modifiers

Documented recurrent AF, atrial flutter or atrial tachycardia Severe left atrial enlargement Significant atrial myopathy, fibrosis or very poor atrial function Other high-risk thromboembolic condition Cannot tolerate long-term anticoagulation or has recurrent clinically important bleeding

CHA₂DS₂-VASc

0

HAS-BLED

0

This tool supports clinical decision-making but does not independently establish that anticoagulation is safe to stop. HAS-BLED identifies modifiable bleeding risks and should not be used by itself to withhold anticoagulation.

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