Martin AC, et al. - In this prospective study including interrupted direct oral anticoagulant (DOAC)–treated patients requiring atrial fibrillation (AF) ablation, researchers tested the hypothesis that the level of anticoagulation at the time of the procedure in uninterrupted DOAC–treated patients is unpredictable and would complicate intraprocedural unfractionated heparin (UFH) administration and monitoring. An unpredictable and highly variable initial level of anticoagulation before catheter ablation was noted consequent to uninterrupted DOAC therapy. Moreover, intraprocedural UFH monitoring was complex even with DOAC interruption preventing interference between DOAC, UFH, and activated clotting time (ACT). Overall, findings argued against the appropriateness of transposing UFH dose protocols, as well as the relevance of ACT monitoring in uninterrupted DOAC–treated patients.