Study Reveals Blood Thinners Unnecessary for Many Afib Patients

A recent international study indicates that patients who have successfully undergone corrective procedures for irregular heartbeats may no longer require long-term blood thinning therapy. The findings, co-led by Canadian researchers and published in the New England Journal of Medicine, could significantly change the clinical management of millions worldwide.

The randomized trial examined over 1,200 patients who received an ablation procedure for atrial fibrillation, a common heart rhythm disorder. This procedure modifies the heart’s electrical signals using a catheter. Researchers compared the outcomes of one group taking rivaroxaban, a widely used anticoagulant, with another group taking low doses of aspirin.

Dr. Atul Verma, a senior cardiovascular scientist at the McGill University Health Centre in Montreal and co-leader of the study, noted that existing guidelines recommended patients continue blood thinners for life, even after successful ablation. “We decided to do this trial to see if this was actually necessary,” he explained.

Atrial fibrillation affects approximately one percent of the Canadian population and increases to five percent among those over the age of 65. After following the patients for three years, the study found no significant difference in stroke or embolism rates between the two groups.

“We were a little surprised by the results,” Verma stated. “It appears that atrial fibrillation ablation, when successful, not only reduces the frequency of atrial fibrillation but also significantly lowers the risk of stroke.” Brain MRIs conducted at the beginning and end of the study revealed low rates of silent strokes among participants, with 96 percent showing no signs of such incidents after three years.

Anticoagulants, known for preventing blood clots, can lead to serious bleeding complications. Verma highlighted that many patients are eager to discontinue these medications due to the associated risks. “The first thing they ask is, can I stop this blood thinner?” he said. “Now for a substantial portion of those patients, I think we can say, yes you can.”

Dr. David Birnie, a professor at the University of Ottawa and head of the Ottawa Heart Institute, called the findings transformative. “Our results show that one year after a successful ablation, the risk of stroke is so low that the downsides of continuing blood thinners outweigh the benefits,” he said in a press release.

The study involved collaboration from over 50 cardiovascular research centres across Canada, Europe, China, and Australia, coordinated by Dr. George Wells, director of cardiovascular research at the Ottawa Heart Institute.

As this research gathers attention, it raises hopes for improved quality of life for patients with atrial fibrillation, allowing for safer activities without the constant worry of blood thinning medication-related complications. The report, originally published on November 8, 2025, signifies a potential shift in how healthcare providers approach treatment for this common heart condition.