Anticoagulation in AF Ablation and Effects on Neurocognitive Function
Atrial Fibrillation, Cerebrothromboembolus, Neurocognitive Function
About this trial
This is an interventional treatment trial for Atrial Fibrillation focused on measuring Atrial Fibrillation Ablation, Cerebrothromboemboli, Neurocognitive Function
Eligibility Criteria
Inclusion Criteria:
- Patients 18 years old and older with AF (paroxysmal or persistent) who are to undergo an elective AF ablation procedure at UCSF will be eligible for enrollment.
Exclusion Criteria:
- Patients will be excluded if they have:
- A contraindication of warfarin therapy (pregnancy, recent bleed, inability of have serial INR checks)
- A contraindication or relative contraindication to interruption of anticoagulation (e.g. mechanical valve, clotting disorder such as antiphospholipid syndrome, recent history of pulmonary embolism or history of recurrent pulmonary embolism)
- A contraindication to transesophageal echocardiogram; any contraindication to MRI
- Have a diagnosed condition of dementia or a diagnosis that precludes accurate assessment of neurocognitive function
- Non-English speakers
- Inability to give informed consent.
Sites / Locations
- University of California, San Francisco
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Interrupted Anticoagulation
Uninterrupted anticoagulation with warfarin
Patients randomized to undergo atrial fibrillation ablation with interrupted anticoagulation with apixaban (5mg twice daily; 2.5mg twice daily >80 years old, Cr > 1.5, wt < 60kg), rivaroxaban (20mg daily; 15mg daily CrCl < 50 mL/minute), dabigatran (150mg twice daily; 75mg twice daily CrCl < 30mL/minute), or warfarin (dosed case-by-case).
Patients randomized to undergo atrial fibrillation ablation with uninterrupted anticoagulation with warfarin (dosed case-by-case).