The researchers conclude that continuous warfarin therapy, from 2 months before catheter ablation to 6 months following, is associated with a very low to non-existent procedure-related risk of ischemic stroke. They also point out that patients, in the proper INR range and not experiencing AF on the day of the procedure, do not need a pre-procedure transesophageal echocardiogram (TEE). Although the standard practice is to keep all ablatees on warfarin for 6 months post-procedure, an exception is made for those with symptomatic AF and a CHADS2 score of 0 who are allowed to go off warfarin after 3 months.
Gopinath, D, et al. Pulmonary vein antrum isolation for atrial fibrillation on therapeutic coumadin: special considerations. Journal of Cardiovascular Electrophysiology, Vol. 22, February 2011, pp. 236-39