New research coordinated by the Ottawa Heart Institute is poised to dramatically improve the lives of millions of people worldwide suffering from atrial fibrillation, the most common cause of irregular heartbeats.
A Paradigm Shift in Post-Treatment Care
For years, the standard medical advice given to the approximately one million people per year who undergo a successful cardiac ablation for atrial fibrillation was that they must remain on blood thinners for life. This was considered a necessary precaution to reduce their elevated risk of stroke. However, a long-awaited international study co-led by Dr. David Birnie, head of the Division of Cardiology at the Ottawa Heart Institute, has turned this practice on its head.
The study's findings, published in the prestigious New England Journal of Medicine, conclude that continuing blood thinners after a successful ablation is unnecessary. The research demonstrates that the risk of stroke in these patients becomes so low that it is as if they never had atrial fibrillation in the first place.
Details of the Landmark International Study
The extensive research project, which began in 2013, involved more than 1,200 patients from around the globe. All participants had undergone a successful cardiac ablation procedure. In a randomized trial, one group of patients continued taking a commonly prescribed blood thinner, while the other group was given low-dose aspirin.
After following the patients for three years, the researchers made a critical discovery: the incidence of stroke was not significantly lower in the group taking powerful blood thinners compared to the group on aspirin. An overwhelming 96 percent of patients in both groups showed no evidence of a new ischemic stroke after three years.
Dr. Birnie, who is also a professor at the University of Ottawa, stated that the impact will be immediate and global. "Doctors will be contacting their patients almost immediately to tell them they can stop blood thinners," he said, confirming this is the advice he will give his own patients.
What This Means for Patients in Canada and Beyond
This research is set to be rapidly translated into clinical practice. It means that the continued use of blood thinners will no longer be recommended in official clinical guidelines for patients who have had a successful treatment for atrial fibrillation.
Cardiac ablation is a minimally invasive day procedure performed at institutes like the Ottawa Heart Institute. It involves creating small scars in the heart via a blood vessel to correct dysfunction in the heart's electrical system. The procedure is successful in about 80 percent of cases.
Atrial fibrillation affects about one percent of all Canadians, with the rate rising to five percent for those aged 65 and over. This breakthrough offers newfound freedom and an improved quality of life for a significant portion of the population, freeing them from the burdens and potential side effects of long-term blood thinner use.
