Resolution of Thrombi in Left Atrial Appendage With Edoxaban

  • End date
    Aug 25, 2023
  • participants needed
  • sponsor
    Keimyung University Dongsan Medical Center
Updated on 25 January 2021
atrial flutter
anticoagulation therapy


Non-valvular (NV) atrial fibrillation (AF) increases the risk of stroke by approximately fivefold. The atrial thrombi associated with AF are seen within the left atrial appendage (LAA) in most cases (> 90%). Anticoagulation with a vitamin-K antagonist (VKA) is recommended to prevent thromboembolic complications and to resolve thrombi. Non-VKA oral anticoagulants (NOACs) have replaced the VKA for the thromboprophylaxis in patients with NVAF since 2010. Therefore, NOAC can be the excellent alternative to VKA concerning resolving preexisting LAA thrombi because of its rapid onset of action and no need of bridging with heparin. However, there is still lack of data regarding the optimal treatment for patients with AF and thrombi in LAA with NOAC. There are only several case reports of the efficacy of NOACs in resolving LAA thrombi available.

Edoxaban, which has data showing efficacy and safety in thromboprophylaxis, can be the new option for treatment of patients with AF and LAA thrombi. The purpose of this study is to evaluate the efficacy of Edoxaban in resolving the LAA thrombi, which is related with nonvalvular AF.

Condition Arrhythmia, Dysrhythmia, Arrhythmia, Atrial Fibrillation, Atrial Fibrillation, Atrial Fibrillation (Pediatric), Atrial Fibrillation (Pediatric), Dysrhythmia, Left Atrial Appendage Thrombosis
Treatment Edoxaban
Clinical Study IdentifierNCT03840291
SponsorKeimyung University Dongsan Medical Center
Last Modified on25 January 2021


Yes No Not Sure

Inclusion Criteria

Men or women aged 20 years
Hemodynamically stable nonvalvular AF or atrial flutter
LAA thrombus documented by TEE up to 72 hours prior to start of study medication
VKA or NOAC-nave or untreated within 1 month prior to sign the informed consent
VKA pretreated but under the therapeutic International Normalized ratio levels (<2.0; documented with at least 2 consecutive measurements that are at least 24 hours apart) within last 6 weeks
Women of childbearing potential and men must agree to use adequate contraception when sexually active

Exclusion Criteria

Transient Ischemic Attack within 3 days prior to study inclusion
Severe, disabling stroke (modified Rankin score of 4-5, inclusive) within 3 months or any stroke within 14 days before the start of study drug
Acute thromboembolic events or thrombosis (venous/arterial) within the last 14 days prior to study inclusion
Acute myocardial infarction within the last 14 days prior to study inclusion
Cardiac-related criteria: Previous intracardiac thrombus, Free-floating ball thrombus, Intracardiac tumor, known left ventricular or aortic thrombus
Active bleeding or high risk for bleeding contraindicating anticoagulant therapy
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