ArticleArchives of medical science : AMS2020
RIVAroxaban TWICE daily for lysis of thrombus in the left atrial appendage in patients with non-valvular atrial fibrillation: the RIVA-TWICE study.
Article in Archives of medical science : AMS, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Comparison of therapeutic strategies in patients presenting with left atrial thrombus despite oral anticoagulation.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Comparison of clinical characteristics, treatment, in-hospital and 12-month outcomes in patients after myocardial infarction with ejection fraction < 40% with or without atrial fibrillation.Archives of medical science : AMS · 2026Article
- Variability of PT-INR values measured by point of care devices INRatio/INRatio 2 and CoaguChek XS and standard laboratory method. A cross-sectional study.Archives of medical science : AMS · 2026Article
- Improvement in age- and sex-dependent mortality in patients with atrial fibrillation between 2011 and 2016 - a nationwide retrospective study from Hungary.Archives of medical science : AMS · 2026Article
- Predictive Role of Metabolic Profiling in Rivaroxaban Efficacy for Thrombus Lysis in Atrial Fibrillation.International journal of molecular sciences · 2025Article
- The Comparative Effectiveness and Safety of Different Anticoagulation Strategies for Treatment of Left Atrial Appendage Thrombus in the Setting of Chronic Anticoagulation for Atrial Fibrillation or Flutter.Cardiovascular drugs and therapy · 2023Article
- Treatment of Persistent Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation on Adequate Oral Anticoagulation: Pathways of Care for All-comers and Heart Failure Patients.Cardiac failure review · 2023Review
- Switching from warfarin to direct-acting oral anticoagulants: it is time to move forward!The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2022Review
- The effects of rivaroxaban, an oral anticoagulant, on human IVD primary cultures.Archives of medical science : AMS · 2022Article
- 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
- Short-Term Apixaban for Documented Left Atrial Appendage Thrombus in High-Risk Atrial Fibrillation Patients Undergoing Left Atrial Appendage Occlusion.TH open : companion journal to thrombosis and haemostasis · 2020Article
- Electric cardioversion in patients treated with oral anticoagulants: embolic material in the left atrial appendage.Cardiovascular journal of AfricaReview
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRivaroxaban is a direct factor Xa inhibitor used once a day for prevention of thrombotic events in patients with atrial fibrillation (AF). However, in a small proportion of subjects thrombus in the left atrial appendage (LAA) is present despite this treatment. The aim of this study was assess the efficacy of increased dose of rivaroxaban (15 mg twice daily) treatment for lysis of thrombus in the LAA. MATERIAL AND
methodsIn the RIVA-TWICE prospective, open label study, with non-blinded patients and blinded outcome assessors, rivaroxaban 15 mg twice daily for 8 weeks was administered in patients with AF who had LAA thrombus despite standard 20 mg once a day therapy. Transesophageal echocardiography was performed at baseline and after 8 weeks. Blood samples were taken to measure the activity of the anti-Xa factor.
resultsFifteen patients (9 males, mean age: 63 ±10 years) were enrolled. Following 8 weeks of rivaroxaban 15 mg twice daily, complete resolution of thrombus in the LAA was observed in 7 (46.7%) patients. The mean activity of anti-Xa factor was significantly higher during rivaroxaban twice daily therapy compared with the standard dose. However, there were no significant differences between effectively and non-effectively treated patients.
conclusionsRivaroxaban 15 mg twice daily seems to be safe and may dissolve LAA thrombus when standard rivaroxaban therapy is ineffective. Lower CHA
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