Apixaban successfully resolved a warfarin-resistant left atrial appendage thrombus in a patient with end-stage renal disease on hemodialysis

The left atrial appendage (LAA) is the major source of thromboembolism in patients with atrial fibrillation (AF). Warfarin or new oral anticoagulants (NOACs) have been used to treat the LAA thrombus; however, the use of NOACs is limited in patients with renal dysfunction. Here, we report the case of a patient with paroxysmal AF and end-stage renal disease (ESRD) requiring hemodialysis, in whom apixaban successfully and safely resolved a LAA thrombus refractory to warfarin