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Randomised controlled trial
Interruption of all anticoagulation is non-inferior to the use of short-term parenteral bridging in patients with atrial fibrillation undergoing invasive procedures
  1. Benjamin A Steinberg
  1. Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
  1. Correspondence to : Dr Benjamin A Steinberg, Duke University Medical Center, Duke Clinical Research Institute P.O. Box 17969, Durham, NC 27715, USA; benjamin.steinberg{at}

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Oral anticoagulation (OAC) has been demonstrated to reduce stroke in patients with atrial fibrillation (AF), however, its use conveys an increased risk of bleeding.1 Therefore, patients receiving OAC who undergo invasive procedures often ‘interrupt’ OAC. Use of short-term ‘bridging’ anticoagulants during such interruptions has been the source of significant debate.2 Although guidelines support a risk-based approach, there is little randomised data to support this.3 Observational data have suggested increased harm and minimal benefit associated with bridging,4 yet until now there have been insufficient prospective …

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  • Competing interests BAS reports research support from Janssen Pharmaceuticals.

  • Provenance and peer review Commissioned; internally peer reviewed.