Key result
Catheter ablation and dual-chamber pacing resolve warfarin-resistant left atrial appendage thrombus in lone AF.
Why the study?
Left atrial appendage thrombi can occur in atrial fibrillation patients despite well-conducted anticoagulant therapy with warfarin, and effective treatment options are needed.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Anticoagulant-resistant LAA thrombus may occur in lone AF; this Level 5 case leaves open questions on optimal management.
Atrial fibrillation is the most common rhythm disturbance and can also occur in absence of true cardiac disease. However, also in these cases, it can generate left atrial appendage thrombi with systemic embolic potential. A regular and well conducted anticoagulant therapy with dicoumarol derivatives, as indicated in these patients, is not always successful. We report the case of a patient with lone atrial fibrillation and a left atrial appendage thrombus resistant to anticoagulant therapy with warfarin, which disappeared after catheter ablation of atrial fibrillation by electrical disconnection of the pulmonary veins, restoration of sinus rhythm and dual-chamber pacemaker implantation.
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Oneglia et al. (2006) conducted a case report in Lone atrial fibrillation with warfarin-resistant left atrial appendage thrombus (n=1). Catheter ablation of atrial fibrillation and dual-chamber pacemaker implantation was evaluated on Disappearance of left atrial appendage thrombus. Catheter ablation of atrial fibrillation and dual-chamber pacemaker implantation led to the disappearance of a warfarin-resistant left atrial appendage thrombus in a patient with lone AF.
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