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Dr. Reiffel has consulted for and/or been an investigator for and/or served on a speakers bureau for Janssen Pharmaceutica, Boehringer Ingelheim, Pfizer, Bristol-Myers Squibb, and Daiichi Sankyo. Address correspondence to: James A. Reiffel, MD, Columbia University c/o 202 Birkdale Lane, Jupiter, FL 33458, USA. Email: jar2@columbia.edu. In this issue of The Journal of Innovations in Cardiac Rhythm Management, Maraj et al.1 report on the periprocedural use of oral anticoagulation therapy in patients undergoing atrial fibrillation (AF) ablation. This manuscript provides a useful review of the issues involved in and the therapeutic choices available with respect to, pre-, intra-, and postprocedural anticoagulant usage. Included is the correct view that we have learned from the earlier days of ablation as well as current approaches that have prompted a reduction in the risk of major bleeding complications while simultaneously keeping embolic consequences low.

Considerations Regarding the Periprocedural Use of Oral Anticoagulation Therapy in Patients Undergoing Atrial Fibrillation Ablation