Arrhythmias & electrophysiologyRandomised controlled trial
Half-dose rivaroxaban vs antiplatelet therapy for preventing silent cerebral embolism after left atrial appendage occlusion: the HALO-SCE trial
- Randomised controlled trial
- investigator-initiated
- prospective
- multicentre
- 1:1
Authors' conclusion
In patients eligible for oral anticoagulation after successful LAAO, rivaroxaban 10 mg daily significantly reduced SCEs and better maintained cognitive function compared with antiplatelet therapy, with numerically fewer composite clinical events.
Study context
- Population
- Patients with successful left atrial appendage occlusion (LAAO) confirmed 45 days post-procedurerandomised
- Participants
- 164 patients
- Comparison
- Half-dose rivaroxaban vs antiplatelet therapy after LAAO
- Half-dose rivaroxabann = 82
- Antiplatelet therapyn = 82reference
- Primary endpoint
- Patient-level incidence of any newly detected silent cerebral embolic lesion (SCE) on diffusion-weighted MRI
- Follow-up
- During (90, 180 and 365 days after LAAO)
Primary result
As reported in the abstract
New SCEs
P = 0.005
Secondary outcomes
| Outcome | model-derived between-group difference (95% CI) | P value | |
|---|---|---|---|
| Mini-Mental State Examination score · 365 days | 2.56 (1.11–4.01) | P < 0.001 | |
| Montreal Cognitive Assessment score · 365 days | 2.67 (1.07–4.26) | P = 0.001 | |
| −20246Difference (linear scale) |
Composite of all-cause mortality, clinical thromboembolic events and major bleeding
P = 0.057
Original publication
Half-dose rivaroxaban vs antiplatelet therapy for preventing silent cerebral embolism after left atrial appendage occlusion: the HALO-SCE trial. Eur Heart J. Published 31 August 2026. doi:10.1093/eurheartj/ehag734
Summarised from the published abstract; every number is checked against it