Short-Term Apixaban for Documented Left Atrial Appendage Thrombus in High-Risk Atrial Fibrillation Patients Undergoing Left Atrial Appendage Occlusion

Stroke prevention with left atrial appendage (LAA) occlusion is an important alternative treatment for high-risk atrial fibrillation (AF) patients with contraindications to oral anticoagulation (OAC).[1] [2] The presence of LAA thrombus detected on preprocedural imaging usually precludes implantation of the endocardial device because of a prohibitively high periprocedural embolic risk.[3] Although successful resolution of LAA thrombus with OAC has been described, all previous reports are in patients without contraindications to OAC.[4] [5] [6] Furthermore, long-term data in these patients are lacking. We hypothesized that short-term OAC with apixaban could safely facilitate resolution of LAA thrombi even in a high-risk population, thereby allowing safe LAA occluder device implantation, with good outcomes over the long term.