ArticleJACC. Case reports2026
Left Atrial Appendage Occlusion for Persistent Thrombus Preventing Rhythm Control.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation is the most common sustained arrhythmia and a major risk factor for cardioembolic stroke. Left atrial appendage occlusion (LAAO) is an established alternative to long-term anticoagulation in selected patients; however, active left atrial appendage (LAA) thrombus is generally considered a contraindication. CASE SUMMARY: A 69-year-old man with hypertension, hyperlipidemia, newly diagnosed nonvalvular atrial fibrillation, and severe left ventricular systolic dysfunction (ejection fraction 20% to 25%) underwent transesophageal echocardiography (TEE) before cardioversion. A large apical LAA thrombus was identified, preventing cardioversion. Despite 9 months of anticoagulation, with apixaban for 2 months followed by warfarin for 7 months, serial TEEs demonstrated persistent thrombus despite supratherapeutic international normalized ratio values as high as 6.9. Following multidisciplinary evaluation, TEE-guided 27-mm Watchman FLX device was successfully performed without complication allowing direct-current cardioversion to normal sinus rhythm with return to normal ejection fraction. DISCUSSION: This case highlights the potential role of LAAO in patients when persistent thrombus prevents definitive rhythm control. TAKE-HOME MESSAGES: Persistent LAA thrombus may remain despite prolonged anticoagulation and can prevent definitive rhythm-control therapy in patients with atrial fibrillation. To recognize persistent LAA thrombus as a barrier to rhythm-control therapy and review the role of LAAO in carefully selected patients with thrombus refractory to anticoagulation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.