Oral anticoagulation (OAC) prevents thromboembolism yet greatly increases the risk of bleeding, inciting concern among clinicians. Current guidelines lack sufficient evidence supporting long-term OAC following successful atrial fibrillation catheter ablation (CA). A literature search was performed in PubMed, Google Scholar, Medline, and Scopus to seek out studies that compare continued and discontinued anticoagulation in post-ablation Atrial fibrillation (AF) patients. Funnel plots and Egger’s test examined potential bias. Via the random-effects model, summary odds ratios (OR) with 95% confidence intervals (CI) were calculated using RevMan (5.4) and STATA (17.0). Twenty studies, including 22 429 patients (13 505 off-OAC) were analyzed. Stratified CHA₂DS₂-VASc score ≥2 examining thromboembolic events (TE) favored OAC continuation (OR 1.86; 95% CI: 1.02-3.40; P = .04). Sensitivity analysis demonstrated this association was attenuated. The on-OAC arm had greater incidence of major bleeding (MB) (OR 0.16; 95% CI: 0.08-0.95; P < .00001), particularly intracranial hemorrhage (ICH) and gastrointestinal bleeding (GI); (OR 0.17; 95% CI: 0.08-0.36; P < .00001) and (OR 0.12; 95% CI: 0.04-0.32; P < .0001), respectively. Our findings support sustained anticoagulation in patients with a CHA₂DS₂-VASc score of ≥2. Due to reduced outcome robustness, physician discretion is still advised.

口服抗凝剂 (OAC) 可预防血栓栓塞，但会大大增加出血风险，引起临床医生的关注。目前的指南缺乏足够的证据支持成功进行心房颤动导管消融 (CA) 后的长期 OAC。在 PubMed、Google Scholar、Medline 和 Scopus 中进行了文献检索，以寻找比较消融后心房颤动 (AF) 患者继续和停止抗凝的研究。漏斗图和 Egger 检验检查了潜在的偏差。通过随机效应模型，使用 RevMan (5.4) 和 STATA (17.0) 计算具有 95% 置信区间 (CI) 的汇总优势比 (OR)。分析了 20 项研究，包括 22 429 名患者（13 505 名非 OAC 患者）。分层 CHA ₂ DS ₂-VASc 评分≥2 检查血栓栓塞事件 (TE) 有利于 OAC 继续使用（OR 1.86；95% CI：1.02-3.40；P  = .04）。敏感性分析表明这种关联减弱了。OAC 组的大出血 (MB) 发生率更高（OR 0.16；95% CI：0.08-0.95；P  < .00001），尤其是颅内出血 (ICH) 和胃肠道出血 (GI)；（OR 0.17；95% CI：0.08-0.36；P  < .00001）和（OR 0.12；95% CI：0.04-0.32；P  < .0001）。_{我们的研究结果支持 CHA 2} DS ₂ -VASc 评分≥2的患者持续抗凝。由于结果稳健性降低，仍建议医生酌情决定。