ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2018
Left atrial thrombus despite continuous direct oral anticoagulant or warfarin therapy in patients with atrial fibrillation: insights into rates and timing of thrombus resolution.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Efficacy and Safety of New Oral Anticoagulants versus Warfarin in the Resolution of Atrial Fibrillation with Left Atrial/Left Atrial Appendage Thrombus: A Systematic Review and Meta-Analysis.Reviews in cardiovascular medicine · 2025Pooled it
- The impact of preoperative left atrial appendage thrombus on surgical outcomes in atrial fibrillation patients undergoing epicardial left atrial appendage closure.Frontiers in cardiovascular medicine · 2026Article
- Echocardiographic assessment of left atrial appendage morphology and function-an expert proposal by the German Working Group of Cardiovascular Ultrasound.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Review
- Persistence of left atrial thrombus in patients with hypertrophic cardiomyopathy and atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- Risk of left atrial appendage thrombus in older patients with atrial fibrillation.Archives of medical science : AMS · 2023Article
- Left Atrial Appendage Thrombosis and Oral Anticoagulants: A Meta-Analysis of Risk and Treatment Response.Journal of cardiovascular development and disease · 2022Review
- Efficacy and Safety Profile of Novel Oral Anticoagulants in the Treatment of Left Atrial Thrombosis: A Systematic Review and Meta-Analysis.Current therapeutic research, clinical and experimental · 2022Article
- Usefulness of transesophageal echocardiography before cardioversion in atrial arrhythmias.Cardiology journal · 2021Article
- Clinical Discussions in Antithrombotic Therapy Management in Patients With Atrial Fibrillation: A Delphi Consensus Panel.CJC open · 2020Article
- Imaging of left heart intracardiac thrombus: clinical needs, current imaging, and emerging cardiac magnetic resonance techniques.Therapeutic advances in cardiovascular diseaseArticle
- Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLeft atrial thrombus (LAT) may be detected by transesophageal echocardiography (TEE) in patients with atrial fibrillation (AF) or flutter (AFL) despite continuous anticoagulation therapy. We sought to examine the rates and timing of LAT resolution in response to changes in anticoagulation regimen.
methodsA retrospective study of 1517 consecutive patients on ≥ 4 weeks continuous oral anticoagulation (OAC) undergoing TEE prior to either direct current cardioversion or catheter ablation for AF or AFL was performed. Patients who had LAT on index TEE imaging and had follow-up TEEs were analyzed.
resultsDespite ≥ 4 weeks of continuous anticoagulation therapy, 63 (4.2%) patients had LAT. Forty-four patients (median age 67 [IQR 58, 74]; 33 [75%] male; 25 [57%] on direct oral anticoagulant [DOAC]) had follow-up TEEs performed. Upon detection of LAT on index TEE, 8 patients switched from warfarin to a DOAC, 21 patients switched from a DOAC to warfarin or another DOAC, and 15 patients remained on the same OAC. Over median 4.2 months (IQR 2.9, 6.6), LAT resolution was seen in 25 (57%) patients. Of the 25 patients who had LAT resolution, 7 (28%) required TEE imaging > 6 months after index TEE to show clearance of thrombus. Rates of LAT resolution were similar between patients who had alterations in OAC and those who did not (52 vs. 60%; P = 0.601).
conclusionsAfter initial detection of left atrial thrombus despite uninterrupted anticoagulation for atrial fibrillation or flutter, > 40% patients have persistent clot despite additional extended anticoagulation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.