Date of Award

4-24-2020

Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

Craig McPherson, MD

Abstract

Nonvalvular atrial fibrillation is the most common sustained arrythmia and an independent risk factor for stroke. Today, 6 million Americans live with this disease. The current standard of care to prevent thrombus formation are anticoagulants such as warfarin. Left atrial appendage occlusion devices are a recently available alternative to long-term anticoagulation. However, it has been learned that thrombus may form on these devices in the early months after deployment, so short-term antithrombotic therapy is recommended for up to 6 months. To date, there have been no studies to determine the optimal antithrombotic therapy regimen post implant. The present study reviews what is known about antithrombotic therapy and proposes a randomized controlled trial to compare the potential utility of direct oral anticoagulant therapy to the presently recommended strategy using warfarin and dual-antiplatelet therapy. Determining the proper antithrombotic profile for post device-placement patients will reduce complications of atrial fibrillation.

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