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DOAC Dose Adjustment in Renal Impairment — EECC MCQ

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HardArrhythmia & ElectrophysiologyDOAC Dose Adjustment in Renal ImpairmentEECC

A patient with CHA2DS2-VA score 3 has no AF detected during the year after apparently successful ablation. What is the preferred anticoagulation strategy?

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Correct answer: EContinue anticoagulation according to baseline thromboembolic risk

Long-term anticoagulation after AF ablation is determined principally by thromboembolic risk, not by symptom status or apparently successful rhythm control. Silent recurrence can occur and stroke mechanisms are not completely eliminated. In this patient the risk score supports continued anticoagulation unless contraindications dictate another strategy. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: 2024 ESC Guidelines for atrial fibrillation. https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/atrial-fibrillation/