Antithrombotic Dilemmas after Left Atrial Appendage Occlusion Watchman Device Placement

Antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF) has dramatically shifted from warfarin, a vitamin K antagonist, to the direct oral anticoagulants (DOACs) such as dabigatran, apixaban, and rivaroxaban. In patients with contraindications to oral anticoagulation,...

Full description

Bibliographic Details
Main Authors: Tania Ahuja, Scarlett Murphy, Daniel J. Sartori
Format: Article
Language:English
Published: Hindawi Limited 2019-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2019/5247105
Description
Summary:Antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF) has dramatically shifted from warfarin, a vitamin K antagonist, to the direct oral anticoagulants (DOACs) such as dabigatran, apixaban, and rivaroxaban. In patients with contraindications to oral anticoagulation, left atrial appendage occlusion (LAAO) devices, such as the Watchman™ device, may be considered; however, temporary postimplantation antithrombotic therapy is still a recommended practice. We present a case of complex antithrombotic management, post LAAO device implantation, designed to avoid drug interactions with concomitant rifampin use and remained necessary secondary to subsequent device leak. This case highlights the challenges of antithrombotic therapy post LAAO device placement in a complex, but representative, patient.
ISSN:2090-6404
2090-6412