Anticoagulation for New-Onset Post-Operative Atrial Fibrillation After CABG

Prior treatment

• Planned use of post-operative dual antiplatelet therapy (DAPT)
  • This includes, but is not limited to, patients with recent PCI with drug-eluting or bare-metal stent.
• Concomitant left atrial appendage closure during CABG
• Concomitant valve surgery during CABG or prior valve surgery (including aortic, mitral, tricuspid or pulmonary)
• Concomitant mitral valve annuloplasty during CABG
• Concomitant carotid artery endarterectomy during CABG
• Concomitant aortic root replacement during CABG
• Concomitant surgery for AF during CABG
• Pharmacologic therapy with an investigational drug or device within 30-days prior to randomization or plan to enroll patient in an investigational drug or device trial during participation in this trial

Other illness

• Clinical history of either permanent, persistent or paroxysmal atrial fibrillation
• Major perioperative complication\* occurring between CABG and randomization
  • including, but not limited to, stroke, TIA, MI, major bleeding (BARC type 4 bleeding), severe sepsis, renal failure requiring dialysis, or need for reoperation due to bleeding (e.g. pericardial tamponade).
• Liver cirrhosis or Child-Pugh Class C chronic liver disease
• Existence of underlying disease that limits life expectancy to less than one year

Other

• Any pre-existing clinical indication for long-term OAC
• Any absolute contraindication to OAC
• Cardiogenic shock
• Pregnancy at the time of randomization
• Unable or unwilling to provide inform consent
• Unable or unwilling to comply with the study treatment and follow-up

• Patients of age ≥18 years who undergo isolated CABG for coronary artery disease
• POAF that persists for \>60 minutes or is recurrent (more than one episode) within 7 days after the index CABG surgery