Related Experiment Video
Updated: May 14, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
[Percutaneous left atrial appendage closure after resolution of left atrial appendage thrombi with dabigatran]
Zsuzsanna Kis1, Csaba Földesi, Mátyás Pál
1Gottsegen György Országos Kardiológiai Intézet Felnőtt Kardiológia Budapest. iszusz11@freemail.hu
Insights
Effective anticoagulation is crucial for preventing atrial fibrillation (AF) related clots. This case report details successful resolution of left atrial appendage thrombi in an AF patient intolerant to standard therapies.
Area of Science:
- Cardiology
- Thrombosis Management
Background:
- Oral vitamin K antagonists are the standard for preventing atrial fibrillation (AF)-related thromboembolic events.
- Many high-risk AF patients do not receive effective antithrombotic therapy due to treatment-related issues.
- Resolving left atrial appendage thrombi in patients intolerant to standard anticoagulants presents a significant clinical challenge.
Observation:
- This report describes a unique case of non-valvular persistent AF with high stroke risk.
- The patient experienced persistent left atrial appendage thrombi despite trials of various standard anticoagulants.
- The patient was intolerant to all "standard" anticoagulant therapies.
Findings:
- This is the first reported instance of successful left atrial appendage thrombi resolution in such a patient.
- Dabigatran therapy led to the successful resolution of left atrial appendage thrombi.
- Percutaneous left atrial appendage closure was also successfully performed in this case.
Implications:
- This case highlights potential therapeutic strategies for complex AF patients.
- It suggests dabigatran and percutaneous left atrial appendage closure as viable options when standard anticoagulation fails.
- Further research may explore these interventions in similar patient populations.
Abstract:
The "gold standard" of the prevention of atrial fibrillation related thromboembolic events is anticoagulation therapy with oral vitamin K antagonists. A certain proportion of high-risk patients with atrial fibrillation are not receiving effective antithrombotic therapy because of problems associated with its use. Resolution of subsequent left atrial appendage thrombi is quite a great challenge in patients who are not tolerating "standard" antithrombotic drugs. According to the knowledge of the authors, this is the first report of a patient with non-valvular persistent atrial fibrillation and high stroke risk, who was intolerant to "standard" anticoagulant therapy and had persistent left atrial appendage thrombi following the use of a wide variety of "standard" anticoagulants. Successful resolution of left atrial appendage thrombi with dabigatran and successful percutaneous left atrial appendage closure were performed in this case.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:24Cardiac Catheterization III: Left Heart Catheterization