Reply : Left Ventricular Thrombus: When Registries Are Not Good Enough !

We have appreciated the valuable comments on our paper (1). Our objectives were to provide a well-documented and contemporary registry of patients with left ventricular thrombus (LVT), underline the need for repeated cardiac imaging to identify thrombus regression, and the need to refine antithrombotic management in these patients.

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We believe that DOAC carry the potential of a favorable risk/benefit ratio in comparison with vitamin K antagonists, but they also raise the question of the right dose to be used for LVT treatment. Similarly, it has been suggested to add an antiplatelet agent in case of incomplete efficacy but with a poor level of evidence. The time has come now for randomized evaluations of the different options in terms of type of treatment and treatment duration.