Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation

Patients with persistent atrial fibrillation (AF) and a large left atrium are at a high risk for thromboembolisms. Recently, direct oral anticoagulants (DOACs) have mainly been used for the prevention of cardiac embolisms caused by AF. Transesophageal echocardiography (TEE) is performed in order to...

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Autores principales: Watanabe, Tetsuya, Shinoda, Yukinori, Ikeoka, Kuniyasu, Minamisaka, Tomoko, Fukuoka, Hidetada, Inui, Hirooki, Hoshida, Shiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577073/
https://www.ncbi.nlm.nih.gov/pubmed/28768967
http://dx.doi.org/10.2169/internalmedicine.56.8508
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author Watanabe, Tetsuya
Shinoda, Yukinori
Ikeoka, Kuniyasu
Minamisaka, Tomoko
Fukuoka, Hidetada
Inui, Hirooki
Hoshida, Shiro
author_facet Watanabe, Tetsuya
Shinoda, Yukinori
Ikeoka, Kuniyasu
Minamisaka, Tomoko
Fukuoka, Hidetada
Inui, Hirooki
Hoshida, Shiro
author_sort Watanabe, Tetsuya
collection PubMed
description Patients with persistent atrial fibrillation (AF) and a large left atrium are at a high risk for thromboembolisms. Recently, direct oral anticoagulants (DOACs) have mainly been used for the prevention of cardiac embolisms caused by AF. Transesophageal echocardiography (TEE) is performed in order to exclude any left atrial appendage (LAA) thrombi. We herein report two cases of persistent AF, both of which were treated with rivaroxaban for more than two years. Since TEE identified mobile LAA thrombi with this treatment, we switched from rivaroxaban to the direct thrombin inhibitor dabigatran. Dabigatran resolved the LAA thrombi that had been refractory to rivaroxaban.
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spelling pubmed-55770732017-09-01 Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation Watanabe, Tetsuya Shinoda, Yukinori Ikeoka, Kuniyasu Minamisaka, Tomoko Fukuoka, Hidetada Inui, Hirooki Hoshida, Shiro Intern Med Case Report Patients with persistent atrial fibrillation (AF) and a large left atrium are at a high risk for thromboembolisms. Recently, direct oral anticoagulants (DOACs) have mainly been used for the prevention of cardiac embolisms caused by AF. Transesophageal echocardiography (TEE) is performed in order to exclude any left atrial appendage (LAA) thrombi. We herein report two cases of persistent AF, both of which were treated with rivaroxaban for more than two years. Since TEE identified mobile LAA thrombi with this treatment, we switched from rivaroxaban to the direct thrombin inhibitor dabigatran. Dabigatran resolved the LAA thrombi that had been refractory to rivaroxaban. The Japanese Society of Internal Medicine 2017-08-01 /pmc/articles/PMC5577073/ /pubmed/28768967 http://dx.doi.org/10.2169/internalmedicine.56.8508 Text en Copyright © 2017 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Watanabe, Tetsuya
Shinoda, Yukinori
Ikeoka, Kuniyasu
Minamisaka, Tomoko
Fukuoka, Hidetada
Inui, Hirooki
Hoshida, Shiro
Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation
title Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation
title_full Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation
title_fullStr Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation
title_full_unstemmed Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation
title_short Dabigatran Therapy Resulting in the Resolution of Rivaroxaban-resistant Left Atrial Appendage Thrombi in Patients with Atrial Fibrillation
title_sort dabigatran therapy resulting in the resolution of rivaroxaban-resistant left atrial appendage thrombi in patients with atrial fibrillation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577073/
https://www.ncbi.nlm.nih.gov/pubmed/28768967
http://dx.doi.org/10.2169/internalmedicine.56.8508
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