Pill-in-the-POCKET Oral Anticoagulation Strategy After AF Catheter Ablation

This trial is testing a "pill-in-the-pocket" anticoagulation (blood thinning) strategy after catheter ablation for atrial fibrillation (AF). Currently, patients typically take blood thinners every day after ablation to prevent stroke. This study tests whether some patients can safely take them only when needed based on monitoring data from a small implanted heart monitor, rather than daily. **You may be eligible if...** - You are 19 to 89 years old - You have AF that has not responded to medication and you are scheduled for catheter ablation - You are currently taking a direct oral anticoagulant (such as rivaroxaban, dabigatran, apixaban, or edoxaban) - Your stroke risk score (CHA2DS2-VASc) is between 1 and 4 - You plan to continue blood thinners long-term to prevent stroke **You may NOT be eligible if...** - You have had a previous stroke or mini-stroke (TIA) - You have a bleeding disorder, significant recent gastrointestinal bleeding, or history of bleeding in the brain or eyes - You have severe anemia or very low platelet counts - You are on dialysis or have severe kidney failure - You have severe liver disease, advanced heart failure (NYHA Class IV), or severe heart valve disease - You have a condition that prevents implanting a small heart monitor under the skin - Your heart arrhythmia is hemodynamically unstable Talk to your doctor to see if this trial is right for you.