{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T12:48:46Z","timestamp":1780058926133,"version":"3.54.0"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left atrial appendage closure (LAAC) is an important approach for stroke prevention in patients with non\u2010valvular atrial fibrillation. Anticoagulation\u2010related spinal epidural hematoma (SEH) and device\u2010related thrombosis (DRT) are rare but serious complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>We report the case of an 86\u2010year\u2010old female who presented with a six\u2010month history of recurrent chest tightness. She was clinically diagnosed with persistent non\u2010valvular atrial fibrillation and chronic heart failure. Following a comprehensive evaluation, she underwent successful LAAC and was started on edoxaban 30\u00a0mg once daily for anticoagulation. At six weeks post\u2010procedure, she developed an anticoagulation\u2010related SEH. Anticoagulation was immediately discontinued. Following conservative management, the hematoma resolved and her muscle strength improved. She was subsequently started on clopidogrel 75\u00a0mg once daily for antiplatelet therapy. At the six\u2010month follow\u2010up, transthoracic echocardiography and computed tomography angiography confirmed a large DRT in the left atrium. Anticoagulation was re\u2010initiated with low\u2010molecular\u2010weight heparin bridging to warfarin, with the international normalized ratio maintained between 2.0 and 2.5. Follow\u2010up imaging at eight months demonstrated significant resolution of the left atrial thrombus. During the remainder of the follow\u2010up period, no further major adverse events, including ischemic stroke or bleeding, occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients with multiple high\u2010risk factors undergoing LAAC, attention should be paid to dynamic adjustment of individualized antithrombotic strategies, enhancement of perioperative procedural quality control, and structured follow\u2010up within key time windows, in order to minimize the risk of complications and optimize the net clinical benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70268","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T06:46:08Z","timestamp":1778136368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Left Atrial Appendage Closure Complicated by Spinal Epidural Hematoma and Device\u2010Related Thrombosis: A Case Report"],"prefix":"10.1111","author":[{"given":"Shufang","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Cardiology Wenzhou Central Hospital  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5643-3402","authenticated-orcid":false,"given":"Qiqi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Cardiology Wenzhou Central Hospital  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanjiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Wenzhou Central Hospital  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjian","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Wenzhou Central Hospital  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.05.038"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.021"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14920"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035090"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.10.046"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14122"},{"issue":"12","key":"e_1_2_12_8_1","first-page":"1697","article-title":"Chinese Expert Consensus on Diagnosis and Treatment of Spinal Epidural Hematoma (2024)","volume":"33","year":"2024","journal-title":"Chinese Journal of Emergency 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History"}},{"value":"2026-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pace.70268"}}