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Case Reports in Cardiology
Volume 2019, Article ID 6076923, 4 pages
Case Report

Successful Resolution of a Large Left Atrial and Left Atrial Appendage Thrombus with Rivaroxaban

1Department of Internal Medicine, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave., Chicago, IL 60657, USA
2Department of Internal Medicine, Flushing Hospital Medical Center, 4500 Parsons Blvd, Flushing, NY 11355, USA
3Department of Cardiology, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave, Chicago, IL 60657, USA

Correspondence should be addressed to Safwan Gaznabi; moc.liamg@ibanzags

Received 16 November 2018; Accepted 20 February 2019; Published 9 April 2019

Academic Editor: Aiden Abidov

Copyright © 2019 Safwan Gaznabi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 79-year-old male was admitted to the hospital for acute exacerbation of heart failure. The patient had history of atrial fibrillation and was planned for cardioversion. Preprocedure transesophageal echocardiogram (TEE) revealed a large multilobulated mobile thrombus in the left atrial appendage. The patient refused warfarin therapy and instead chose to take rivaroxaban. Upon outpatient follow-up, 3 months later, no visible thrombus was appreciated on repeat TEE. This case demonstrates successful resolution of left atrial and left atrial appendage thrombi with the use of rivaroxaban. At present time, limited data is available to support the use of rivaroxaban for treatment of intracardiac thrombi. This case highlights the need for further studies to investigate the outcomes and relative efficiency of use of direct oral anticoagulants (DOACs) in lysis of intracardiac thrombus. The benefits of DOACs compared to the standard of therapy could increase patient compliance, reduce length of stay, and improve treatment efficacy.