title: [Right atrial appendage thrombosis during atrial fibrillation: an element to look for].
abstract: Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT. After neurological consult, OAT was resumed with apixaban 5 mg twice daily, and transesophageal echocardiography performed two months later showed complete resolution of the right atrial appendage thrombosis. This particular case underlines the importance of searching for a possible right atrial appendage thrombosis in patients affected by AF, and suggests that left atrial appendage closure in AF patients not suitable for OAT does not fully eliminate the risk of thromboembolism.
authors.affiliation: S.C. Cardiologia, Ospedale San Bassiano, Bassano del Grappa (VI).
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barbati
authors.affiliation: S.C. Cardiologia, Ospedale San Bassiano, Bassano del Grappa (VI).
authors.forename: Renato
authors.initials: R
authors.lastname: De Domenico
authors.affiliation: S.C. Radiologia, Ospedale San Bassiano, Bassano del Grappa (VI).
authors.forename: Stefania
authors.initials: S
authors.lastname: Rossi
authors.affiliation: S.C. Pronto Soccorso, Ospedale San Bassiano, Bassano del Grappa (VI).
authors.forename: Elena
authors.initials: E
authors.lastname: Vecchiato
authors.affiliation: S.C. Cardiologia, Ospedale San Bassiano, Bassano del Grappa (VI).
authors.forename: Roberto
authors.initials: R
authors.lastname: Zeppellini
mesh_terms: D020517:Atrial Appendage / Q000601:surgery; D001281:Atrial Fibrillation / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology*