AMSTERDAM — Among patients with atrial high-rate episodes detected by implantable devices, anticoagulation with edoxaban did not significantly reduce the incidence of a composite outcome of cardiovascular death, stroke, or systemic embolism in comparison with placebo but was associated with a higher bleeding risk in the NOAH-AFNET 6 trial.”These results tell us that patients with atrial high-rate episodes with clinical stroke risk factors ― but who do not have clinically defined AF ― do not need blood thinners. They do not need to be anticoagulated. That is a relief,” the lead investigator of the trial, Paulus Kirchhof, MD, University Heart and Vascular Center Hamburg, in Germany, commented to theheart.org | Medscape Cardiology.Kirchhof pointed out that this result was unexpected. “Many of us thought that because atrial high-rate episodes look like AF when they occur, then they are an indication for anticoagulation. But based on these results from the first-ever randomized trial on this population, there is no need for anticoagulation in these patients.”Kirchhof presented the NOAH-AFNET 6 trial on Friday at the European Society of Cardiology (ESC) Congress 2023, which is being held here in Amsterdam, the Netherlands. The study was also simultaneously published in The New England Journal of Medicine.