Thrombi outside the left atrial appendage: “small potatoes”?

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with the development of atrial thrombi and the risk of embolisation. A detrimental manifestation after embolisation of these thrombi is ischaemic stroke, with 15-20% of all ischaemic strokes occurring in patients with AF1. The increased thromboembolic risk depends on various risk factors. Therefore, current guidelines recommend risk stratification by CHA2DS2-VASc score to estimate the need for oral anticoagulation (OAC) therapy in patients with AF2.

Several randomised controlled trials (RCTs) demonstrated a two-thirds reduction in the incidence of stroke using vitamin K antagonists (VKA) compared to ...