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Left ventricular thrombus (LVT) is not uncommon and pose a risk of systemic embolism, which can be mitigated by adequate anticoagulation. Direct oral anticoagulants (DOACs) are increasingly being used as alternatives to warfarin for anticoagulation, but their efficacy and safety profile has been debated.
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On the basis of limited data, patients with nonischemic cardiomyopathy with LV thrombus should be treated with OAC for at least 3–6 months, with discontinuation if LV ejection fraction improves to >35% (assuming resolution of the LV thrombus) or if major bleeding occurs.
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