Рациональная фармакотерапия в кардиологии
Т. 14, Вып. 3, С. 350-355
Аннотация:
The article presents a clinical observation of the left atrial appendage thrombosis in a 51-year-old female patient with a paroxysmal form of nonvalvular atrial fibrillation which occurred despite long-term anticoagulant therapy with apixaban in a full dose (5 mg b.i.d.), and the patient's management. The patient was admitted with recurrent symptomatic paroxysm for more than 48 hours, because of which, in accordance with the recommendations, transesophageal echocardiography was performed before an emergency rhythm restoration. Thrombus in the left atrial appendage 0.5×1.03 cm in size was detected. It was decided to refrain from the immediate restoration of the rhythm due to the very high risk of thromboembolic complications. In connection with the categorical refusal of the patient from warfarin, it was decided to replace apixaban with another direct oral anticoagulant - dabigatran 150 mg bid for a period of 4 weeks followed by performing a control transesophageal echocardiographic stu
Ключевые слова:
Apixaban; Atrial fibrillation nonvalvular etiology; Dabigatran; Direct oral anticoagulants; Left atrial appendage thrombosis
apixaban; dabigatran; adult; Article; atrial fibrillation; case report; clinical article; comorbidity; disease severity; drug substitution; drug withdrawal; female; heart atrium appendage; high risk patient; hospital admission; human; hypertrophic cardiomyopathy; insulin dependent diabetes mellitus; left atrial appendage thrombosis; middle aged; thrombosis; transesophageal echocardiography; treatment refusal
Даабоул И. С.
Королева С. Ю. Светлана Юрьевна 1995-
Кудрйавцева А. А.
Соколова А. А. Анастасия Андреевна 1983-
Напалков Д. А. Дмитрий Александрович 1975-
Фомин В. В. Виктор Викторович 1978-
Daaboul I. S.
Koroleva S. Yu. Svetlana Yuryevna 1995-
Kudrjavtseva A. A.
Sokolova A. A. Anastasiya Andreevna 1983-
Napalkov D. A. Dmitrij Aleksandrovich 1975-
Fomin V. V. Viktor Viktorovich 1978-
Thrombosis of left atrial appendage during therapy with direct oral anticoagulant. Clinical case
Текст визуальный непосредственный
Рациональная фармакотерапия в кардиологии
Столичная издательская компания
Т. 14, Вып. 3 С. 350-355
2018
Статья
Apixaban Atrial fibrillation nonvalvular etiology Dabigatran Direct oral anticoagulants Left atrial appendage thrombosis
apixaban dabigatran adult Article atrial fibrillation case report clinical article comorbidity disease severity drug substitution drug withdrawal female heart atrium appendage high risk patient hospital admission human hypertrophic cardiomyopathy insulin dependent diabetes mellitus left atrial appendage thrombosis middle aged thrombosis transesophageal echocardiography treatment refusal
The article presents a clinical observation of the left atrial appendage thrombosis in a 51-year-old female patient with a paroxysmal form of nonvalvular atrial fibrillation which occurred despite long-term anticoagulant therapy with apixaban in a full dose (5 mg b.i.d.), and the patient's management. The patient was admitted with recurrent symptomatic paroxysm for more than 48 hours, because of which, in accordance with the recommendations, transesophageal echocardiography was performed before an emergency rhythm restoration. Thrombus in the left atrial appendage 0.5×1.03 cm in size was detected. It was decided to refrain from the immediate restoration of the rhythm due to the very high risk of thromboembolic complications. In connection with the categorical refusal of the patient from warfarin, it was decided to replace apixaban with another direct oral anticoagulant - dabigatran 150 mg bid for a period of 4 weeks followed by performing a control transesophageal echocardiographic stu