Discontinuation of Anticoagulations After Successful Catheter Ablation of Atrial Fibrillation
Start Date
8/5/2025
Completion Date
12/31/2029
Summary
The DESTINATION Study investigates whether anticoagulation therapy is necessary after successful catheter ablation (CA) for atrial fibrillation (AF). Current guidelines recommend continued anticoagulation based on stroke risk scores, even post-ablation, potentially exposing patients to unnecessary bleeding risks. This international, multicenter, randomized controlled trial aims to compare thromboembolic and bleeding event risks between patients who continue and discontinue anticoagulation after ablation. The study involves 3,160 AF patients, all free of AF recurrence within 6 months to 1 year after ablation. Smart wearable monitors will track recurrence, and patients are followed for 24 months to assess event rates. Findings may reshape anticoagulation guidelines, improving clinical practice for AF patients worldwide.
Detailed Description
This prospective, international, multicenter randomized controlled trial (RCT) investigates the safety and necessity of continuing anticoagulation therapy after successful catheter ablation of atrial fibrillation. The study will enroll 3,160 patients who underwent catheter ablation for AF and achieved no recurrence within 6 months to 1 year post-procedure. Participants will be randomly assigned to either continue or discontinue anticoagulation therapy. Smart wearable devices will monitor AF recurrence every 3 months, detecting both symptomatic and asymptomatic events. The study\'s primary endpoint is a composite of ischemic stroke, systemic embolism, and major bleeding at a 24-month follow-up. Secondary outcomes include AF recurrence rates, re-ablation needs, and quality of life measures. Participants are monitored through follow-up visits at 3, 6, 12, 18, and 24 months, and data from wearable devices will be transmitted to the research team. This study is significant due to the diversity of the population, with sites in China and the US, allowing for results that are generalizable across ethnic and geographic lines. The trial\'s findings aim to provide high-quality evidence to inform future guideline recommendations regarding post-ablation anticoagulation therapy, potentially reducing unnecessary bleeding risks and optimizing treatment outcomes. The inclusion of smart wearable monitors enhances the detection of asymptomatic recurrences and provides continuous, reliable data on patient health during the follow-up period.
Eligibility Criteria
Age Range: 18 years to No maximum
Interventions
discontinue anticoagulation therapy
Anticoagulant drugs
Catheter Ablation
Conditions
Locations
Brigham and Women Hospital
Boston, Massachusetts 02115
United States
Beijing Anzhen Hospital
Beijing, Beijing Municipality 100011
China
Fuwai Hospital
Beijing, Beijing Municipality 100037
China
The First Affiliated Hospital, Sun Yat-sen University
Guangzhou, Guangdong
China
Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
Shenzhen, Guangdong
China
Fuwai Central China Cardiovascular Hospital
Zhengzhou, Henan
China
Wuhan Asia Heart Hospital
Wuhan, Hubei
China
Shanghai Chest Hospital
Shanghai, Shanghai Municipality
China
Shanxi Cardiovascular Hospital (Shanxi Cardiovascular Research Institute)
Taiyuan, Shanxi
China
West China Hospital, Sichuan University
Chengdu, Sichuan
China
Yunnan Fuwai Cardiovascular Hospital
Kunming, Yunnan
China
Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang
China