{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:31:29Z","timestamp":1789396289670,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke\u2010prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC). Group 1 patients were further divided into Gr. 1A: LAAO\u2009+\u2009half\u2010does NOAC (HD\u2010NOAC) for 6 months followed by aspirin 81\u2009mg\/day and Gr. 1B: LAAO\u2009+\u2009HD\u2010NOAC. In group 1 patients, with complete occlusion at the 45\u2010day transesophageal echocardiogram, patients were switched to aspirin, 81\u2009mg\/day at 6 months. In case of leak, or dense \u201csmoke\u201d\u00a0in the left atrium (LA) or enlarged LA, they were placed on long\u2010term half\u2010dose (HD)\u00a0NOAC. Group 2 patients remained on full\u2010dose NOAC during the whole study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 92 patients were included in the analysis; group 1: 56 and group 2: 36. After the 45\u2010day TEE, 31 patients from group 1 remained on baby\u2010aspirin and 25 on HD\u00a0NOAC. At 1\u2010year follow\u2010up, four stroke, one\u00a0TIA and six device\u2010thrombus were reported in group 1A, compared to none in patients in group 1B (5\/31 vs. 0\/25, <jats:italic>p<\/jats:italic>\u2009=\u2009.03). No bleeding events were reported in group 1, whereas group 2 had five bleeding events (one subdural hematoma, one retinal hemorrhage, and four\u00a0GI bleedings). Additionally, one stroke was reported in group 2 that happened during brief discontinuation of OAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with coexistent AF and amyloidosis, half\u2010dose NOAC following LAAO was observed to be the safest stroke\u2010prophylaxis strategy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16308","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T04:23:46Z","timestamp":1715833426000},"page":"1422-1428","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Best anticoagulation strategy with and without appendage occlusion for stroke\u2010prophylaxis in postablation atrial fibrillation patients with cardiac amyloidosis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-944X","authenticated-orcid":false,"given":"Sanghamitra","family":"Mohanty","sequence":"first","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prem Geeta","family":"Torlapati","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo Mirco","family":"La Fazia","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Kurt","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"},{"name":"Department of Internal Medicine Mount Auburn Hospital Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-7207","authenticated-orcid":false,"given":"Carola","family":"Gianni","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Mayedo","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Allison","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bassiouny","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Joseph","family":"Gallinghouse","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Horton","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":false,"given":"Luigi","family":"Di Biase","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology Albert Einstein College of Medicine at Montefiore 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