Anticoagulant Therapy in Patients With Atrial Fibrillation After Surgical Left Atrial Appendage Closure: a Randomized Non-inferiority Trial (The ATLAAC Trial)

What this Trial Is About

Researchers are evaluating the safety of stopping anticoagulant therapy in patients with atrial fibrillation who have had surgical closure of the left atrial appendage (LAA). This procedure is often done during cardiac surgery to reduce the risk of stroke and blood clots, which may allow patients to avoid ongoing blood thinners that increase bleeding risk. The ATLAAC trial is designed as a phase 4 randomized study to compare continued versus discontinued anticoagulation in this group. Participants will have undergone cardiac surgery with LAA closure verified by a cardiac CT scan. Those with successful closure are randomly assigned to either stop taking oral anticoagulants (such as warfarin or direct oral anticoagulants) or to continue them for the trial duration. This allows the trial to assess the risk of ischemic stroke, peripheral arterial embolism, and major bleeding events between the two approaches. During the approximately four-year follow-up, participants will be monitored for stroke severity, transient ischemic attacks, mortality rates, minor bleeding, and other cardiovascular events. Quality of life and patient satisfaction with treatment will also be evaluated at baseline and yearly intervals. The trial involves regular assessments to ensure safety and to measure key health outcomes related to anticoagulation status after LAA closure.

Can Patients With Atrial Fibrillation Safely Discontinue Anticoagulant Therapy After Cardiac Surgery? (ATLAAC)