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Updated: Mar 10, 2026
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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Left Atrial Appendage Thrombus Resolution with Reduced Dose Apixaban.
Beatriz Vaquerizo1, Magdi Sami1
1Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.
Journal of Atrial Fibrillation
|December 14, 2016
Summary
This case study shows low-dose Apixaban effectively resolved left atrial appendage clots in a patient with recent stroke and hemorrhage. It highlights Apixaban
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- A patient with persistent atrial fibrillation experienced a massive stroke with hemorrhagic transformation after warfarin reversal.
- Standard stroke prevention methods like left atrial appendage occlusive devices (LAAOD) were contraindicated due to hemorrhage risk.
Observation:
- Transesophageal echocardiography revealed left atrial appendage (LAA) clots, precluding LAAOD implantation.
- Computed tomography showed only partial resolution of the cerebral hematoma.
Findings:
- Reduced-dose Apixaban (2.5 mg twice daily) successfully resolved LAA clots within two months.
- Apixaban treatment did not worsen the existing cerebral hematoma, which continued to resolve.
Implications:
- This case is the first to demonstrate complete resolution of left atrial thrombus with reduced-dose Apixaban.
- The findings suggest a potential role for low-dose Apixaban in specific high-risk patient populations.
- The case also provides insights into anticoagulation management, specifically bridging after warfarin reversal with vitamin K.
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