Clinical decisions in patients with left atrial appendage thrombus despite chronic use of: apixaban (A), dabigatran (B), edoxaban (C), and rivaroxaban (D). DAPT, dual antiplatelet therapy; LMWH, low-molecular weight heparin; NOAC, non-vitamin K antagonist oral anticoagulant; UFH, unfractionated heparin; VKA, vitamin K antagonist.