Treatment failure of low molecular weight heparin bridging therapy in atrial fibrillation after acute coronary syndrome

Abstract

Thrombosis prevention in atrial fibrillation [1–21] is a very common problem for cardiologists. Low molecular weight heparin bridging therapy (LMWH-BT) has been considered in patients at high risk of thromboembolism during the start or temporary interruption of oral anticoagulation therapy [22–24]. Several cases of treatment failure of LMWH-BT have been reported [25–27]. A 70-year-old man, with a history of arterial hypertension, recurrent atrial fibrillation and mild aortic valve stenosis in oral anticoagulant therapy [1–33], came to our observation for inferior STEMI (Fig. 1A) complicated by total BAV (Fig. 1B).