Atrial fibrillation and thrombophilia. DOAC as a valid alternative? A clinical case

Abstract

Perorální antikoagulace znamenala revoluci v léčbě fi brilace síní (FS). Ve složitých případech, včetně některých typů trombofi lií jako postižení zvyšujících riziko tromboembolie, může být warfarin neúčinný. Ukázalo se, že přímá perorální antikoagulancia (direct oral anticoagulants, DOAC) jsou plně hodnotnou možností léčby; jako účinný a bezpečný se osvědčil zvláště edoxaban. Popisujeme případ muže s FS a trombofi lií, u něhož došlo přes antikoagulační léčbu warfarinem k vytvoření trombu v oušku levé síně; následně byla zahájena léčba edoxabanem.

Coronary evagination after self-apposing stent deployment: a rare but possible event. A clinical case at 4-year follow-up

“…Coronary evagination is a coronary abnormality whose pathogenesis can be divided in non-iatrogenic (CAD, vasculitis, connective tissue diseases and so on) and iatrogenic. 1,[5][6][7] Despite plenty of studies and researches, vessel remodeling mechanisms in post-PCI scenario are not completely clear yet, although multiple factors are apparently involved. Firstly, device-related factors, including drug, stent material, design, and the interaction with adjunctive therapy such as coronary atherectomy may play a role.…”

Sino-atrial block due to Guillan-Barré syndrome: a rare case

“…One month later, at ambulatory evaluation, PM interrogation showed permanent AF and rivaroxaban 110 mg BID was than prescribed. 17,32,33 Three days later he came back with edema and pain at superior left limb, which was also warm and blushed. Patient reported to have started anticoagulation therapy just the day before.…”

“…According to Ata Soleimani Rahbar et al, patients with atrial fi brillation (AF) have 8 times higher (OR 8) risk to develop thrombus on endocavitary leads. [14][15][16][17] CHF and either pacemaker leads number and material have been described as important predisposing factors in clot formation on device leads. 3,14,18,19 Diagnosis is echocardiographic: classical Echo-Color-Doppler (ECD) may be suffi cient, but in case of endocavitary thrombus trans-esophageal echocardiography (TEE) is required.…”