Balancing the risk of two bad outcomes, brain damage from a bleed or clot, is the challenge. This paper provides evidence that in a selected group of patients, namely those afib free at 1 yr post ablation, had better outcomes off anticoagulants. I think a lot of conservative cardiologists will be taking patients off anticoagulants based on this paper. A head bleed can be more devastating than a stroke. In patients who are active and willing to do monitoring, discontinuation of anticoagulants is a really good thing. Apixaban ain’t cheap!