Risultati per: Linee Guida per le cure post-parto

Circulation, Volume 150, Issue Suppl_1, Page A4144823-A4144823, November 12, 2024. Post-Acute Sequelae of SARS-CoV-2 infection (PASC) have become a significant healthcare burden. Sustained increases in prothrombotic markers have been reported in hospitalized acute COVID-19 patients. However, whether patients with less severe acute infection also endure a persistent prothrombotic state remains uncertain. We tested for a prothrombotic state in this cohort and examined potential mediators. We enrolled 70 adult patients with prior mild acute SARS-CoV-2 infection and sustained PASC symptoms (per WHO criteria). A control healthy group matched for age and sex was also enrolled who were not previously diagnosed with COVID-19. Markers of platelet activation and platelet-neutrophil aggregates (PNA) were quantified using whole-blood flow cytometry. Markers of extracellular traps (citrullinated histones [H3Cit] and cell-free DNA [cfDNA]), anti-dsDNA IgG, and thrombin generation potential were measured in plasma. At recruitment (6 weeks to 3 years post infection), there was increased potential for thrombin generation in the plasma from PASC compared to control reflected by increased peak and velocity index (P

Circulation, Volume 150, Issue Suppl_1, Page A4142259-A4142259, November 12, 2024. Background:A reduction or delay in myocardial flow and perfusion, despite recanalization of the epicardial coronary arteries, is a well-known phenomenon. However, the association between microvascular resistance and troponin levels following elective percutaneous coronary intervention (PCI) is not well established.Objective:The present study aimed to assess the angiographic-derived index of microcirculatory resistance (AMR) in patients undergoing elective PCI and its relationship with high-sensitivity troponin (hsT) values post-procedure.Methods:Between June 2021 and December 2023, patients who underwent elective PCI were considered for inclusion. Patients with successful PCI outcomes were selected for the IMR analysis using AngioPlus Core (Shanghai Pulse Medical Technology Inc); individuals with branch occlusion were excluded. All patients had hsT collected at least twice in the first 24 hours after PCI.Results:A total of 330 patients were included into the analysis. Compared with baseline, there was an increase in AMR in 89.6% of the patients, from 174.9 pre-PCI to 256.2 post-PCI (p< 0.001, Figures 1A-C). The higher the hsT peak after PCI, the greater the delta IMR (p = 0.004, Figure 1D) and the post-PCI IMR (p < 0.001, Figure 1E). There was a positive and significant correlation between the absolute values of hsT peak and delta IMR (p < 0.001, Figure 1F).Conclusion:In patients who underwent elective successful PCI, the increase in hsT is closely related to increase in the index of microcirculatory resistance during the procedure.

Circulation, Volume 150, Issue Suppl_1, Page ASu1101-ASu1101, November 12, 2024. Introduction:Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are interventions that can increase survival rates of out-of-hospital cardiac arrests (OHCA). However, willingness and comfort levels of such interventions amongst laypersons vary greatly, especially in racial and ethnic minoritized groups including African Americans and Hispanics.Research Question:To assess the comfort level and perceived barriers of participants before and after community-based CPR and AED education.Methods:We conducted a family-centered quasi-experimental study in primarily Black and Hispanic churches around the Will and Dupage counties of Illinois. Informed consent was obtained. Participants watched an instructor-facilitated CPR and AED 10-minute educational video. Comfort levels pre- and post-training were assessed on a scale of 1 (least confident) to 5 (extremely confident) and reported as percentages. A semi-structured questionnaire was used to assess perceived barriers to performing CPR.Results:Out of 27 participants who completed training assessment, majority were females 55.6% (n=15), with 44.4% (n=12) males; 66.7% (n=18) African Americans, and 33.3% (n=9) Hispanic or Latino. 70.4% (n=19) of the participants spoke English while 29.6% (n=8) spoke Spanish. Before training, 73% (n=19) and 81% (n=21) of participants were not confident in administering CPR or using AED respectively on someone in cardiac arrest. After training, confidence level increased to 100% for both CPR and AED use. Perceived barriers to CPR prior to training included participants not knowing how to perform CPR correctly (65%), concern that they may further harm someone (4%), concerns about potential legal liability (4%), and loss of recall on how to perform CPR (4%), while 23% had no barrier.Conclusion:Comfort levels of individuals performing CPR and AED use increased significantly after community-based CPR and AED education. Data collection is ongoing to assess comfort level with a larger number of participants. Implementing community-based CPR training in churches allows for community-oriented CPR trainings and may help improve bystander comfort level and willingness to perform CPR during OHCA, especially in minoritized communities.

Circulation, Volume 150, Issue Suppl_1, Page A4143067-A4143067, November 12, 2024. Background:Atherogenesis often develops in regions with disturbed blood flow (d-flow), involving increased ERK5 and p53 SUMOylation due to SENP2 T368 phosphorylation, leading to increased ERK5 and p53 SUMOylation, contributing to endothelial cell (EC) activation. Conversely, laminar flow (l-flow) induces SENP2 S344 phosphorylation, reducing ERK5 and p53 SUMOylation, thereby suppressing EC activation. The presence of senescent ECs in atherosclerotic plaques suggests that d-flow-induced EC senescence may contribute to atherogenesis, possibly due to metabolic changes. EC glycolysis is crucial for NO production and atheroprotection, however, it is inhibited by l-flow, indicating that l-flow protective effects extend beyond glycolysis.Methods:In ECs from wild-type mice exposed to l-flow, the expression of DDIAS increases, regulated by SENP2 S344 phosphorylation. DDIAS interacts with ACLY, a key regulator of fatty acid metabolism and vascular function. We performed LC-MS and IC-MS analyses on ECs with DDIAS knocked down or control siRNA exposed to l-flow, using13C2-gucose or13C5-glutamine to trace metabolic changes. HMG-CoA, acetyl-CoA, and CoQ levels were measured using LC-MS and triple quadrupole LC-MS/MS.Results:L-flow enhances glycolysis and glutaminolysis, significantly increasing TCA cycle intermediates through upregulated glutamine pathways. DDIAS expression and its interaction with ACLY are also increased by l-flow. Without DDIAS, the ACLY-mediated mevalonate pathway is inhibited, reducing l-flow-induced antioxidant mechanisms. Thus, the DDIAS-ACLY complex is crucial for the antioxidant response triggered by L-flow, which is essential for supporting angiogenesis after hindlimb ischemia. L-flow-induced increases in HMG-CoA and CoQ are inhibited by DDIAS depletion, highlighting the importance of DDIAS in maintaining the balance of metabolic and antioxidant pathways under L-flow.We are investigating the role of DDIAS-ACLY complex on l-flow-mediated upregulation of glycolysis and glutaminolysis.Conclusion:DDIAS plays a key role in mediating l-flow atheroprotective effect by directly interacting with and activating ACLY, essential for the mevalonate pathway and subsequent HMG-CoA and CoQ biosynthesis. Under l-flow conditions, ECs preferentially utilize glutamine over glucose for TCA cycle intermediates, underscoring the importance of the DDIAS-ACLY complex in supporting EC protection and function through enhanced metabolic pathways.

Circulation, Volume 150, Issue Suppl_1, Page A4146947-A4146947, November 12, 2024. Background:The prevalence of both obesity and the use of left ventricular assist devices (LVAD) is increasing in pediatrics, but what impact obesity has on post-heart transplant (HT) outcomes when using an LVAD as a bridge to transplant (BTT) is unknown.Methods:Retrospective cohort study of patients 12-18 years old in the UNOS database with a durable LVAD and listed for heart transplant (HT) between 7/1/2004-12/31/2021. Demographic and clinical variables were assessed. Patients were classified as overweight (BMI≥85-

Circulation, Volume 150, Issue Suppl_1, Page A4140722-A4140722, November 12, 2024. Background:Racial disparities have been well described in cardiovascular disease. However, the impact of race on the outcomes post atrial fibrillation (AF) ablation is not well understood.Objective:This study aim to investigate the clinical outcomes post AF ablation among Black and White patients.Method:The TriNeTX Global Collaborative Network database was used to identify patients aged ≥18 years of age from January 2000 to April 2023 which included atrial fibrillation post-ablation patients. Patients were categorized into two groups, one with Black or African American race and another with White race groups. Both groups were followed for 12 months. We used the international Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify comorbidities, and ICD-10 Procedure coding system for procedures. Propensity score-matched analysis (PSM) (1:1) was performed on age, gender, BMI, smoking, hypertension, diabetes mellitus, chronic kidney disease, hemoglobin level and left ventricular ejection fraction. The primary outcome was all-cause mortality (ACM), while secondary outcomes were ischemic stroke, hemorrhagic stroke, acute myocardial infarction (AMI), MACE (composite of ACM, heart failure, AMI, and ischemic stroke) and heart failure (HF).Result:After 1:1 propensity score matching, the study cohort comprised 10, 335 Black patients and 10,335 White patients. The mean age of patients was comparable between both groups (65.2 and 64.9 years). Post ablation, Black patients were having a significantly higher risk of ACM (RR 1.131, 95% CI: 1.002-1.277), HF (RR 1.473, 95% CI: 1.290-1.683), AMI (RR 1.312, 95% CI: 1.117-1.342), and MACE (RR 1.416, 95% CI: 1.250-1.603) as compared with white population. However, the risk of ischemic stroke (RR 1.069, 95% CI: 0.878-1.301) and hemorrhagic stroke (RR 1.466, 95% CI: 0.908-2.369) were found comparable between Black and White patients post ablation.Conclusion:These findings suggest that Black patients post AF ablation were having a higher risk of mortality and MACE.

Circulation, Volume 150, Issue Suppl_1, Page A4146021-A4146021, November 12, 2024. Background:Heart failure with preserved ejection fraction (HFpEF) or heart failure with reduced ejection fraction (HFrEF) is a common comorbidity in patients undergoing transcatheter aortic valve replacement (TAVR). However, post-TAVR outcomes among HFpEF and HFrEF patients have not been well studied.Objective:This study aims to investigate the clinical outcomes post-TAVR among patients with HFrEF vs. HFpEF.Methods:The TriNeTX Global Collaborative Network research database was used to identify patients aged ≥18 years from January 2005 to May 2023. Patients were categorized into two groups: HFpEF and a control group with HFrEF, with both groups of patients undergoing TAVR and followed for 1-month and 1-year. Propensity score-matched analysis (PSM) (1:1) was performed on age, gender, race, body mass index, hypertension, diabetes mellitus, chronic kidney disease, smoking status, hemoglobin level, low density lipid (LDL) level, and various drugs including ACEi, ARBi, beta-blockers, SGLT2i and statins. Primary outcome was all-cause mortality (ACM), while secondary outcomes were acute myocardial infarction (AMI), ischemic stroke, hemorrhagic stroke, major bleeding and major adverse cardiovascular event (MACE) (composite of ACM, AMI and ischemic stroke).Results:After 1:1 propensity score matching (Figure 1), the study cohort comprised of 11, 982 patients in HFpEF with TAVR and 11, 982 patients in the control group. The mean age of patients in HFpEF and HFrEF was 81.7 and 81.5 years, respectively. PSM analysis showed that post-TAVR outcomes among HFpEF patients were significantly associated with lower risk of ACM after 1-month (RR, 0.88 (95%CI: 0.707-0.953),P=0.009), and after 1-year (RR, 0.93 (95% CI: 0.87-0.99),P=0.041) compared with the HFrEF group. A similar trend was observed with a significant reduction in the risk of MACE after 1-month (RR, 0.86, (95% CI: 0.74-0.99),P=0.043), however, it was non-significant after 1-year (RR, 0.942 (95% CI: 0.881-1.007),P=0.077). However, the risk of AMI, ischemic stroke, hemorrhagic stroke, major bleeding both at 1-month and 1-year follow up were comparable between the HFpEF and HFrEF post-TAVR.Conclusion:In patients with HFpEF post-TAVR, there was a significant decrease in ACM at 1-month and 1-year, while there was a significant reduction in MACE only at 1-month. Further investigation is warranted to determine whether HFpEF has better clinical outcomes than patients with HFrEF.

Circulation, Volume 150, Issue Suppl_1, Page A4139840-A4139840, November 12, 2024. Background:sodium-glucose cotransporter 2 inhibitors (SGLT2i) , a new type of oral hypoglycemics agent used to treat type 2 diabetes, have a positive effect on the progression of heart failure, but there is a concern with the association between SGLT2i and acute kidney injury (AKI).Materials and Methods:We retrospectively evaluated consecutive patients undergoing CABG surgery from January 2018 to December 2021 in the hospital. A cohort of patients who had been prescribed SGLT2i was identified and matched by propensity score with a cohort of patients who had not been prescribed SGLT2i in a ratio of 1:3. The primary outcome was AKI following CABG. Furthermore, a meta-analysis was conducted on the relationship between SGLT2i and acute kidney injury (AKI). Four studies, comprising a total of 25,116 patients, were included in the analysis.Results:A total of 403 patients who had received SGLT2i and 1209 without SGLT2i were included in the analysis. AKI was observed in 54 patients (13.4%) in the SGLT2i group and 373 patients (30.9%) in the non-SGLT2i group following CABG. The SGLT2i exhibited a lower incidence of AKI compared with the non-SGLT2i (P < 0.001). The findings of the meta-analysis indicated that SGLT2i was associated with a decreased incidence of AKI (P < 0.001; OR= 0.525, [95% CI, (0.437-0.631]).Conclusion:The results of our prospective study indicated a reduced risk of AKI in patients undergoing CABG and were treated with SGLT2i.

Circulation, Volume 150, Issue Suppl_1, Page A4118018-A4118018, November 12, 2024. Introduction:Patients with congenital heart disease (CHD) are at increased risk of cancer. In patients with CHD and advanced heart failure, isolated heart transplantation (HT) can be considered. In the overall HT population, immunosuppression after HT increases the risk of post-transplant malignancy (PTM). However, cancer outcomes among adult HT patients with CHD have not been investigated.Methods:Patients aged ≥ 18 years who received HT between January 1, 2010 and December 31, 2021 were identified using the United Network for Organ Sharing (UNOS) registry. Patients with CHD were compared to those without. Outcomes were PTM and hematologic malignancy (either leukemia, lymphoma or post-transplant lymphoproliferative disorder). Multivariable Fine-Gray competing-risk regression adjusting for age, sex, race, prior cardiac surgery, smoking, diabetes, induction immunosuppression, recipient and donor cytomegalovirus and Ebstein-Bar virus status was used to estimate subhazard ratio (SHR).Results:Of the total of 29,717 patients with HT were included, 1,017 (3.4%) had CHD. Patients with CHD were younger, more likely to be female, and more likely to have had prior cardiac surgery. After multivariable competing-risk regression, CHD was associated with higher risk of PTM (aSHR 1.44, 95% CI 1.15 – 1.80) and hematologic malignancy (aSHR 2.09, 95% CI 1.28 – 3.42). Among patients < 45 years old, CHD had an unadjusted SHR of 1.55 (95% CI 1.11 – 2.16) of PTM, Figure.Conclusions:Among adult patients with HT, CHD was associated with increased risk of PTM and hematologic malignancy. Further investigation is warranted to identify risk factors and screening strategies for malignancy in this patient population.

Circulation, Volume 150, Issue Suppl_1, Page A4146872-A4146872, November 12, 2024. Introduction:Increased prevalence and incidence of heart failure has resulted in a significant rise in the number of patients progressing to advanced heart failure (AHF). Heart transplant improves morbidity and mortality in patients with heart failure refractory to medical therapy. We examined resource utilization as measured in 30-day readmission in a contemporary population utilizing the NRD database.Aim:We conducted a thorough analysis to identify trends in 30-day readmissions of HTs and analyze the associated costs.Methods:Using the National Readmission Database from 2010 to 2021, the study focused on new HT recipients. We evaluated various parameters, including readmission rates and the costs associated with 30-day readmissions. Patients aged

Circulation, Volume 150, Issue Suppl_1, Page A4134630-A4134630, November 12, 2024. Background:Over 3 million percutaneous coronary interventions (PCI) are performed yearly to treat coronary artery stenosis. Stent thrombosis is a catastrophic complication associated with high morbidity and mortality, and its prevention requires the use of prolonged dual antiplatelet therapy (DAPT), which increases bleeding risk. Within the first 30 days after PCI, the mortality of DAPT-associated major bleeding is on par with recurrent myocardial infarction.Research question:No stent system that provides focal antiplatelet activity to prevent stent thrombosis exists, eliminating the need for systemic DAPT and subsequent bleeding risk.Aim:To address this unmet need, we have developed such a stent, termed “the ticagrelor coated stent” (TCS).Methods:Self-assembled monolayers (SAMs) of 12-aminododecylphosphonic acid (ADPA) were formed on cobalt-chromium stents. The amine tail group of ADPA was used to link the ticagrelor molecule through a Mitsunobu reaction and confirmed via infrared spectroscopy. Coating uniformity was validated via atomic force microscopy. In an ex-vivo porcine arterio-venous fistula model, the ticagrelor-coated stents (TCS) were placed in alternating series adjacent to uncoated bare metal stents (BMS). Similarly, TCS and everolimus-eluting stents were placed in the porcine left circumflex arteries for acute (7 days) and chronic (35 days) studies.Results:(Figure 1): Grossly, no thrombus was seen on the TCS compared to the BMS. Platelet and micro-thrombi adherence were significantly reduced on TCS. Notably, inflammation, measured by neutrophil and monocyte adherence, was also reduced by approximately 10-fold on the TCS vs the BMS. Angiography, optical coherence tomography (OCT), and histopathology results show the TCS widely patent without systemic DAPT.Conclusion:These findings show that TCS prevents stent thrombosis through focal anti-platelet action and may reduce the bleeding risk associated with prolonged use of systemic DAPT. Long-term safety and efficacy studies are underway.

Circulation, Volume 150, Issue Suppl_1, Page A4145489-A4145489, November 12, 2024. Introduction:Pulmonary Arteriovenous Malformations (PAVMs) are a main surgical complication of second-stage palliative Glenn shunt for single ventricle. PAVMs lead to early mortality. Currently there is no available treatment as its physiopathology remains unknown.Hypothesis:This study hypothesizes that hepatic-derived factor causing PAVMs could be proteome-derived.Goals:To discern differences in proteomic profiles of patient-paired serum from superior vena cava (SVC) and hepatic vein (HV) as a preliminary approach to identify PAVM-related hepatic vein blood-enriched factors.Methods:Paired full blood samples were collected from SVC and HV origin during routine cardiac catheterization of patients with diverse cardiac congenital malformations from 0 to 1 years of age (n=3). Serum was extracted and high abundant proteins were depleted. Single-pot solid-phase-enhanced sample preparation method and trypsinization digestion coupled with label-free data-dependent acquisition liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis was performed. Subgroup differential expression analysis by abundance ratio (SVC/HV) (Adj. P-Value

Circulation, Volume 150, Issue Suppl_1, Page A4140630-A4140630, November 12, 2024. Introduction:Efforts to stratify mortality risk in pulmonary hypertension (PH) have focused on the minority of patients in WSPH group 1. Metabolomic studies in group 1 identify histidine, polyamines, tRNA metabolites, and homoarginine as predictors of mortality. Little is known about the role of metabolomics to predict mortality in the larger group of PH patients.Question:Which serum metabolites predict a composite of mortality or transplant in pre-capillary, post-capillary, and combined pre- and post-capillary PH (Cpc-PH), irrespective of WSPH group?Aims:To identify predictive metabolites in the Pulmonary Vascular Disease Phenomics Program (PVDOMICS) cohort and understand the pathobiology relating predictors to mortality/transplant.Methods:We generated peripheral venous metabolomic data in 649 PH subjects. We defined pre-capillary PH as pulmonary vascular resistance (PVR) >2 WU and pulmonary capillary wedge pressure (PCWP)≤15 mmHg (n = 453), post-capillary PH as PVR≤2 WU and PCWP >15 mmHg (n=25), and Cpc-PH as PVR >2 WU and PCWP >15 mmHg (n = 171). We used Cox models with multiple testing correction to identify predictive metabolites in each group. We then correlated select predictors with hemodynamic, laboratory, and echocardiographic data.Results:The hemodynamic groups included a mix of WSPH groups. We identified 249 predictors in pre-capillary PH, 0 in post-capillary PH, and 7 in Cpc-PH. Homoarginine predicts mortality/transplant in pre-capillary PH (HR=0.56, p

Circulation, Volume 150, Issue Suppl_1, Page A4116298-A4116298, November 12, 2024. Background:Utreglutide (GL0034), a novel, once weekly glucagon-like peptide-1 receptor agonist (GLP-1RA), previously demonstrated significant reductions in body weight (BW) after a single dose ascending study in individuals with obesity.BW reductions after pharmacological treatment of obesity with GLP-1RA is associated with blood pressure (BP) lowering effects.Aim:This phase I study assessed the safety, tolerability, and cardio-metabolic effects of utreglutide after multiple ascending doses in post-menopausal female volunteers with overweight and obesity.Methods:In this randomized, double-blind, placebo-controlled study 12 post-menopausal female volunteers with overweight/obesity, aged 18 to 65 years old with a body mass index (BMI) ≥26 kg/m2were randomized (9:3) to subcutaneous utreglutide fixed doses (4 × 450 µg); or placebo once weekly for four weeks. Safety, tolerability, and key cardio-metabolic parameters were assessed. Biomarker measurements included oral glucose tolerance test (OGTT) insulin and glucose area under the curve (AUC), systolic- and diastolic BP, lipid profile (triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL), and non-high-density lipoprotein (non-HDL), creatinine, potassium, BW and leptin.Results:Utreglutide was generally well tolerated and related adverse effects were mainly gastrointestinal with dose-dependent nausea, vomiting and decreased appetite. Reductions in OGTT AUCs of insulin (p

Circulation, Volume 150, Issue Suppl_1, Page A4146173-A4146173, November 12, 2024. Background:Recurrent atrial fibrillation (AF) occurs in approximately 20 to 40% of patients following catheter ablation. SGLT2 inhibitors (SGLT2i), known for their cardiovascular benefits beyond glycemic control in type 2 diabetes, exhibit multiple pleiotropic effects. These effects offer glucose-independent and direct cardiac protection, potentially enhancing atrial remodeling. Studies suggest that SGLT2 inhibitors may also reduce atrial tachyarrhythmia and lower the risk of recurrence after the initial ablation procedure.Methods:We conducted a systematic review and meta-analysis following PRISMA guidelines. Studies were identified from three databases up to May 2024: MEDLINE/PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. Primary outcomes included AF recurrence with secondary outcomes of left ventricular ejection fraction (LVEF) improvement, hospitalizations and adverse events. Data was extracted and analyzed using R/R Studio. Random effects model was utilized to calculate odds ratios (OR) and 95% confidence intervals (CI).Results:Six studies were included with 5,456 participants (2,514 in SGLT2i group, 2,942 in control group). SGLT2i significantly reduced AF recurrence (OR = 0.44, 95% CI: 0.29-0.67, I2= 65%, p = 0.01). Four studies with 1,044 participants showed a non-significant trend towards LVEF improvement with SGLT2i (OR = 1.99, 95% CI: 0.99-3.99, I2= 0%, p = 0.88). Hospitalization rates from five studies (5,184 participants) showed no significant difference between groups (OR = 1.07, 95% CI: 0.63-1.82, I2= 46%, p = 0.12). Adverse events in four studies (734 participants) were not significantly higher in the SGLT2i group (OR = 1.19, 95% CI: 0.56-2.52, I2= 0%, p = 0.53).Conclusions:The results suggest that SGLT2i use significantly reduces AF recurrence following catheter ablation, with a trend toward LVEF improvement, though not statistically significant. Hospitalization rates and adverse events did not significantly differ between the SGLT2i and control groups, indicating a favorable safety profile. These findings support the potential benefit of SGLT2i in post-ablation management. Further large-scale randomized controlled trials are needed to confirm these results.

Circulation, Volume 150, Issue Suppl_1, Page A4141879-A4141879, November 12, 2024. Background:Current guidelines recommend oral anticoagulation (OAC) for at least two months post-radiofrequency ablation (RFA) in all patients with atrial fibrillation (AF). The endothelial injury during RFA that can promote thrombus formation, does not happen in pulsed-field ablation (PFA).Objective:We evaluated the optimal duration of OAC therapy needed for effective stroke prevention following PFA.Methods:Consecutive patients undergoing PFA for AF were included in the study and prospectively followed-up for 1 year. Based on the duration of post-ablation OAC [non-vitamin K OAC (NOAC)] therapy they were classified intogroup 1:NOAC for 1 month and group 2: NOAC for ≥2 months. Patients were closely monitored for thromboembolic (TE) events via telemedicine. Stroke/transient ischemic attacks that occurred while the patients were in full compliance with the anti-thrombotic therapy, were counted as the reportable TE events.Results:A total of 120 patients were included in this analysis. The mean age of the study population was 59.80 ± 16.39 years; 70 (58%) were male and the CHA2DS2-VASc score was 4.27 ± 1.22. Mean number of PFA applications given was 76.64 ± 36.04.Group 1included 49 (40.8%) andgroup 2was comprised of 71 (59.2%) patients. Baseline characteristics were comparable between the groups.At 1 year,no stroke or transient ischemic attacks were reported in group 1 and 2. At that time point, 42 (85.7%) and 60 (84.5%) patients were arrhythmia-free in group 1 and 2 respectively (p=0.85).Conclusion:In this series of patients, OAC could be safely discontinued after 1 month following the PFA procedure. Thus, it seems redundant to continue OAC beyond 1 month after PFA.