What is the clinical evidence from this study?

Study design: Case Report. Population: Giant left atrial appendage thrombus (n=1). Intervention: Rivaroxaban. Primary outcome: Resolution of thrombus.

What question did this study set out to answer?

This report aims to demonstrate the efficacy of rivaroxaban in resolving a giant thrombus in the left atrial appendage in a patient with atrial fibrillation.

January 1, 2013Thrombosis and Haemostasis

Resolution of giant left atrial appendage thrombus with rivaroxaban

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Key result

Rivaroxaban treatment resulted in the resolution of a giant left atrial appendage thrombus.

Why the study?

Does rivaroxaban resolve giant left atrial appendage thrombus in a patient with persistent atrial fibrillation?

Key Points

This report aims to demonstrate the efficacy of rivaroxaban in resolving a giant thrombus in the left atrial appendage in a patient with atrial fibrillation.
Patient was switched from VKA therapy to rivaroxaban after TEE revealed giant thrombus formation.
Rivaroxaban was administered at a dosage of 15 mg once daily for six weeks.
Transesophageal echocardiography was performed to monitor thrombus size pre- and post-treatment.
Initial thrombus size was 12 x 45 mm, which significantly decreased after four weeks of rivaroxaban treatment.
Complete thrombus resolution was achieved after six weeks of anticoagulant therapy with rivaroxaban.
Successful external cardioversion was performed without clinical signs of cardiac embolism.

Study Design

Type

Case Report (n=1)

Structured PICO

Does rivaroxaban resolve giant left atrial appendage thrombus in a patient with persistent atrial fibrillation?

Population

1 patient (64-year-old man) with symptomatic persistent atrial fibrillation, NYHA class III, ischaemic cardiomyopathy with severely impaired LVEF, CKD stage 3B-4, and a giant LAA thrombus despite VKA therapy.

Intervention

Rivaroxaban 15 mg oral once daily for 6 weeks

Outcome

Resolution of left atrial appendage thrombus assessed by transesophageal echocardiographysurrogate

Rivaroxaban may be effective in resolving giant left atrial appendage thrombi that are refractory to vitamin K antagonists.

Discussion

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Implication

May support rivaroxaban in select VKA-refractory LAA thrombus; leaves open need for controlled trials.

Cite This Study

Pötzsch et al. (2013) conducted a case report in Giant left atrial appendage thrombus (n=1). Rivaroxaban was evaluated on Resolution of thrombus. Rivaroxaban treatment resulted in the resolution of a giant left atrial appendage thrombus.

synapsesocial.com/papers/6a0662bd3f8bf83a443dd91e https://doi.org/10.1160/th12-11-0821

Topics

Left atrial appendage closure Anticoagulation in AF

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Resolution of giant left atrial appendage thrombus with rivaroxaban

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Resolution of giant left atrial appendage thrombus with rivaroxaban

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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