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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Resolution of left ventricular thrombus with apixaban in a patient with hypertrophic cardiomyopathy

Adnan Kaya1, Mert İlker Hayıroğlu2, Muhammed Keskin1

  • 1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|July 4, 2016
PubMed

Insights

Warfarin is the standard treatment for intracardiac thrombus. This report details a case where apixaban effectively resolved left ventricular thrombus in a hypertrophic cardiomyopathy patient with atrial fibrillation.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Intracardiac thrombus management typically involves warfarin.
  • Novel oral anticoagulants (NOACs) are approved for stroke prevention in atrial fibrillation (AF) but not specifically for intracardiac thrombus resolution.
  • Hypertrophic cardiomyopathy (HCM) is a potential risk factor for thrombus formation.

Observation:

  • A 60-year-old female patient presented with left ventricular (LV) thrombus secondary to HCM and AF.
  • Oral anticoagulation was indicated for both AF and the LV thrombus.

Findings:

  • Treatment with apixaban, a NOAC, resulted in the complete resolution of the LV thrombus within one month.
  • This represents the first reported case of LV thrombus resolution using apixaban in a patient with HCM.

Implications:

  • Apixaban may be a viable therapeutic option for resolving LV thrombus in select patients with HCM and AF.
  • Further research is warranted to explore the efficacy and safety of NOACs in intracardiac thrombus resolution.

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