Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?

That is a great question, thank you for bringing it up. The answer really depends on the likely etiology of the intracerebral hemorrhage. For example, if the hemorrhage is subcortical and the etiology is thought to be likely related to hypertension, it is reasonable to resume anticoagulation when sa...

One of my strategies of staying practical is working from treatment backwards.

I believe the folks who get the left atrial appendage closure post-op are immediately placed on warfarin + antiplt and or dual antiplt and or NOAC + antiplt.

Warfarin + antiplt / NOAC + antiplt has been strongly discourag...

If the anticoagulant was warfarin, and the INR was supratherapeutic, starting warfarin with a lower INR goal or substituting a DOAC would make sense. If on a DOAC already, I would strongly consider LAA closure. If there is evidence of a Cerebral Amyloid Angiopathy related bleed, then I would move to...