Anticoagulation Protocol
All patients in the pre-and post-COVID epochs were treated with a
minimally interrupted anticoagulation strategy. Patients treated with
warfarin continued uninterrupted therapy throughout the ablation period.
Patients treated with direct oral anticoagulants (DOACs) underwent
cessation of anticoagulation for 12–24 hours prior to the ablation
procedure, with resumption 4 hours post-procedure. Adherence to a
prescribed anticoagulation regimen was assessed by international
normalized ratio (INR) for warfarin-treated patients or by verbal
confirmation (for NOAC-treated patients) pre-and post-procedure. During
the ablation procedure itself, activated clotting time levels were
maintained above 350s with intravenous heparin during LA access.
Anticoagulation was continued for a minimum of 3 months following the
ablation procedure for all patients unless contraindicated.