{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:05:31Z","timestamp":1790053531795,"version":"4.0.1"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":263,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Case Reports in Cardiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pacemaker lead thrombosis is a rare but serious complication of cardiac implantable electronic devices (CIEDs) that often mimics infection; its management, given the lack of standardized treatment strategies, requires individualized anticoagulation and dynamic imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 65\u2010year\u2010old woman with heart failure and diabetes mellitus had previously undergone dual\u2010chamber pacemaker implantation following radiofrequency catheter ablation. After the subsequent occurrence of ventricular tachycardia, the device was upgraded to a cardiac resynchronization therapy defibrillator (CRT\u2010D). She later experienced recurrent atrial flutter accompanied by worsening heart failure. The timing of atrial flutter recurrence was uncertain, and the patient had not received anticoagulation therapy. Preoperative transesophageal echocardiography (TEE) revealed a mobile mass measuring 10 \u00d7 3.5\u2009mm attached to the right atrial lead. Comprehensive clinical and laboratory evaluation showed no evidence of infection. Anticoagulation with rivaroxaban at 20\u2009mg once daily was initiated; however, no reduction in thrombus size was observed after 1 month. The treatment regimen was therefore switched to warfarin, with an initial target international normalized ratio (INR) of 2.0\u20133.0. Follow\u2010up TEE performed 3 months later demonstrated enlargement of the thrombus to 18 \u00d7 3.8\u2009mm. The target INR was subsequently intensified to 2.5\u20133.0, after which the thrombus gradually regressed. Serial TEE examinations confirmed complete thrombus resolution by 6 months. No embolic or bleeding complications occurred during the treatment course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case underscores the inadequacy of NOAC monotherapy in selected high\u2010risk patients with lead\u2010associated thrombus, and demonstrates that INR\u2010guided warfarin therapy with individualized adjustment was effective in achieving thrombus resolution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cric\/6121153","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:42:02Z","timestamp":1790052122000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Resolution of Right Atrial Pacemaker Lead Thrombosis After Rivaroxaban Failure: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6700-1823","authenticated-orcid":false,"given":"Bowen","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5695-4251","authenticated-orcid":false,"given":"Zhan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4461-2995","authenticated-orcid":false,"given":"Qi","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3056-4267","authenticated-orcid":false,"given":"Ping","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1159\/000007018"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.115.002942"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/23247096211010048"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029608323088"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.08.008"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2016-134414"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2014.11.037"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-015-0085-2"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-008017"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-210314"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14647"}],"container-title":["Case Reports in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/6121153","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cric\/6121153","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/6121153","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:42:18Z","timestamp":1790052138000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cric\/6121153"}},"subtitle":[],"editor":[{"given":"Satabdi","family":"Datta Choudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cric\/6121153"],"URL":"https:\/\/doi.org\/10.1155\/cric\/6121153","archive":["Portico"],"relation":{},"ISSN":["2090-6404","2090-6412"],"issn-type":[{"value":"2090-6404","type":"print"},{"value":"2090-6412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6121153"}}