Abstract
We present five patients with non-valvular atrial fibrillation (NVAF) with left atrial thrombus, which was detected by transesophageal echocardiography for acute-phase cardioembolic stroke and disappeared after dabigatran etexilate (DE) administration. The mean age at onset was 83 years, and three of the five patients were women. The mean maximum diameter of the left atrial thrombi was 13 mm. Unfractionated heparin was administered and then switched to DE in three patients, and warfarin started before the stroke onset was switched to DE in one patient. In one patient, warfarin started before the onset was switched to unfractionated heparin after the onset and then switched to DE (110 mg b.i.d. for 4 patients, 150 mg b.i.d. for 1 patient). With DE administration for a mean of 18 days (range, 6–39 days) starting 3, 5, 5, 7, and 18 days after the onset, the left atrial thrombus resolved completely without recurrent ischemic events in all patients. The results of this study suggest the efficacy of early administration of DE for the prevention of recurrent thromboembolism in NVAF patients with acute-phase cardioembolic stroke and positive left atrial thrombus.
