Key result
Apixaban and WATCHMAN fail to prevent left atrial thrombus post-cardioversion in a patient with AF.
Why the study?
Current guidelines recommend cardioversion without routine preprocedural TEE in patients compliant with oral anticoagulation for at least 3 weeks, but their relevance remains unclear in patients undergoing repeat cardioversion.
Population
A 66-year-old male with AF and an LAAO device compliant with apixaban
Design
Case report
Authors
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May support preprocedural TEE before repeat cardioversion in LAAO patients on anticoagulation; hypothesis-generating case report requiring confirmation.
Case Report (n=1)
This case suggests that preprocedural TEE may be warranted before repeat cardioversion in patients with LAAO devices on anticoagulation, as thrombus can still form.
Ahmed et al. (2024) conducted a case report in Atrial fibrillation (n=1). Apixaban and WATCHMAN device was evaluated on Device-related thrombus formation. Apixaban therapy and a WATCHMAN device did not prevent the formation of a 2 cm by 1 cm left atrial thrombus 10 days post-cardioversion in a 66-year-old male with atrial fibrillation.
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