Stroke due to Left Atrial Appendage Thrombus after Pulmonary Vein Isolation despite Novel Oral Anticoagulant: A Case Report.

Abstract

In patients with atrial fibrillation, catheter ablation is suggested to reduce the mortality rate and is thus frequently performed. However, peri- and postprocedural thromboembolic complications as well as high recurrence rates of atrial fibrillation limit its advantages and require concomitant anticoagulation. With the advent of novel oral anticoagulants (NOACs), fixed dosing without routine laboratory monitoring became feasible. Nevertheless, several factors are associated with either an overdose or an insufficient drug activity of NOACs. We report on a patient with atrial fibrillation undergoing catheter ablation and cardioversion suffering from ischemic stroke despite being under oral anticoagulation. It turned out that the drug activity of the NOACs used was repeatedly insufficient in spite of regular intake and adequate dosing. In sum, drug activity controls should be taken into consideration in patients with thrombotic events despite oral anticoagulation with NOACs.

• Authors: Woon Hyung Chae, Heinrich Wieneke, Iryna Dykun, Cornelius Deuschl, Martin Köhrmann, Benedikt Frank
• Journal: Case reports in neurology (Case Rep Neurol) 2021 Jan-Apr Vol. 13 Issue 1 Pg. 225-232 ISSN: 1662-680X [Print] Switzerland
• PMID: 33976660 (Publication Type: Case Reports)
• Copyright: Copyright © 2021 by S. Karger AG, Basel.