Dabigatran for intra-cardiac thrombus; Yet another promising role for novel oral anti-coagulants: A case report

Until recently, warfarin has been the main stay of treatment for thrombo-prophylaxis in atrial fibrillation (AF) patients. Indeed, with the emergence of new novel oral anticoagulants (NOACs) unsurprisingly there has been a noteworthy switch in the choice of antithrombotic treatment of AF patients. Nevertheless, still warfarin appears to be the drug of choice in patients with intra-cardiac thrombus (either left atrial thrombus or left ventricular mural thrombus). We report, a case of middle aged patient with recent onset atrial fibrillation and left atrial appendage thrombus with subsequent complete dissolution of thrombus following dabigatran treatment for 6-weeks. Despite, the promising results from limited case reports with NOACs, its efficacy and safety in the treatment of intra-cardiac thrombus needs to be evaluated in large randomised controlled trials.