Could taking blood thinners only when needed be just as safe as daily pills?
NCT ID NCT06216769
First seen Jun 27, 2026 · Last updated Jun 27, 2026
Summary
This study compares two approaches to taking blood thinners after a common heart procedure for atrial fibrillation. One group takes blood thinners every day as usual, while the other takes them only when a small implanted monitor detects an irregular heartbeat. The goal is to see if the 'as-needed' approach can prevent strokes and bleeding just as well. About 400 adults at risk for stroke will participate.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
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Not a phased trial
Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.
- Participants
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About 400 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Feb 2024
- Expected to finish
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Dec 2030
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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19 to 89 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: 1. Patients who are scheduled to undergo atrial fibrillation catheter ablation due to atrial fibrillation refractory to antiarrhythmic drug treatment. 2. Patients with non-gender CHA2DS2-VASc score 1-4. 3. Patients who are taking direct oral anticoagulants (rivaroxaban, dabigatran, apixaban, edoxaban) and further plan taking them life-long to prevent stroke caused by atrial fibrillation. 4. Patients aged 19-89 (inclusive) who voluntarily sign the informed consent form. Exclusion Criteria: 1. Patients with a stroke/transient ischemic attack history. 2. Patients with underlying diseases and bleeding findings contraindicated to anticoagulation (e.g., coagulation disorders, bleeding conditions, significant gastrointestinal bleeding within 6 months of enrollment, history of intracranial/intraocular/nontraumatic bleeding, thrombolysis within 48 hours of study enrollment). 3. Patients who are contraindicated to anticoagulants other than those listed above. 4. Patients who are hemodynamically unstable at the time of study enrollment: cardiogenic shock, treatment-unresponsive ventricular arrhythmia, or congestive heart failure (NYHA class IV) at the time of randomization. 5. Patients with underlying severe anemia (hemoglobin \<8 g/dL at baseline) or a transfusion history within four weeks before visit 1. 6. Patients with underlying severe thrombocytopenia (platelet count \<50,000/mm3) 7. The patient is under dialysis or chronic renal failure (creatinine clearance \<15ml/min) 8. The patient has severe liver disease (variceal bleeding, ascites, hepatic encephalopathy, or jaundice). 9. The patient has a contraindication to the implantation of an implantable loop recorder (ILR) (such as limited immunocompetence or a wound-healing disorder). 10. The patient has severe valvular disease (valvular prosthesis, mitral valve repair; rheumatic mitral stenosis is excluded irrespective of the severity of the disease). 11. The patient has a non-arrhythmic condition necessitating long-term oral anticoagulation. 12. Hypertrophic cardiomyopathy 13. The patient is deemed high risk for non-cardioembolic stroke (i.e. significant carotid artery disease). 14. Patients who are taking warfarin or coumadin. 15. Patients who are taking dual antiplatelet agents. 16. Pregnancy, breastfeeding, or women of childbearing age who refuse to use a highly effective and medically acceptable form of contraception throughout the study. \* \* Medically acceptable contraceptives include condoms, injectable or implantable contraceptives, intrauterine devices, and oral contraceptives. 17. Known or suspected malignancy with a history of chemotherapy within 1 year. 18. The patient has previously implanted cardiac implantable electronic devices or ILR. 19. Patients with a history of left atrial appendage occlusion or left atrial appendage closure. 20. The patient is participating in another randomized clinical trial and is under follow-up observation.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
1 site. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Seoul National University Hospital
RECRUITINGSeoul, South Korea
More trials for these conditions
Other studies related to the condition(s) this trial covers.
- Heart hole or stroke trigger? global registry tracks who gets closure and what happens next
- Two ways to quiet a racing heart: trial pits hybrid ablation against standard catheter treatment
- Stroke's hidden heart rhythm clue under investigation
- Suture device may get heart patients walking sooner after leg vein procedures
- Two ways to catch a hidden heart rhythm after stroke
- Can an implanted heart monitor catch hidden irregular heartbeats after stroke?