For patients with AF and stable coronary artery disease (eg, no acute coronary syndrome within the previous year) and who choose oral anticoagulation, we suggest OAC with either an NOAC or adjusted- dose VKA therapy alone (target international normalized ratio [INR] range, 2.0-3.0) rather than the combination of OAC and aspirin (Weak recommendation, low quality evidence). Catheter or Surgical Ablation, Electrophysiological Procedures Periprocedural Anticoagulation for Catheter Ablation and Implantable Devices: Randomized trials have shown that uninterrupted warfarin is safe and superior to warfarin interruption for implantation of cardiac implantable electronic devices.7 For catheter ablation, anticoagulation guidelines pertinent to cardioversion generally apply to periprocedural anticoagulation and are detailed in a recent professional society expert consensus In a randomized trial of 1,584 patients, uninterrupted warfarin, compared with interruption with heparin bridging, has been shown to have a lower risk of periprocedural stroke and bleeding.298 A randomized trial of uninterrupted rivaroxaban vs uninterrupted VKA in AF ablation demonstrated similar event rates in both arms.299 A similar randomized trial of uninterrupted dabigatran found that dabigatran was associated with fewer bleeding complications than uninterrupted warfarin.300 Although these studies were open-label, they strongly support the use of uninterrupted anticoagulation for electrophysiology procedures (Table 9).298-301 Two recent systematic reviews with meta-analyses that include studies with such patients consistent with Long-term Anticoagulation After Restoration of Sinus Rhythm Clinical observations indicate that AF and stroke are often temporally discordant, with stroke occurring during periods of sinus rhythm in the majority of patients with paroxysmal AF.304,305 After catheter ablation, discontinuation of OAC is associated with an increased risk of stroke.297 Similarly, postoperative AF may confer a long-term risk of stroke. 