Patients with more severe complications of RHD are at risk of developing a very serious electrical disturbance which causes the heart to "fibrillate". This means instead of a steady, regular and well controlled beat which is relevant to what a person is doing at the time, the normal electrical control of contraction is lost and the atrial chambers in the heart beat very fast and out of control.  

When this happens blood flow through the heart chambers can become sluggish with a high risk of the blood clotting in the heart.  Blood clots can leave the left side of the heart and end up in the brain.  If that happens the patient develops what is called “stroke” which can cause paralysis or death.  In patients who have what is known as atrial fibrillation it is important that we prevent the blood from clotting.  Traditionally this has been done effectively with a drug known as Warfarin.  

 

However, Warfarin requires exceptionally careful administration and control through monthly blood samples and dosage changes.  Rivaroxaban is a new anti-coagulant with a proven safety profile which does not require such invasive monitoring.  This clinical trial across 7 countries is being done to establish the safety and efficacy when used for our RHD patients with atrial fibrillation.  The research team is awaiting permission from the Ministry of Health and Social Services and hopes to initiate this research in 2017.  

Rivoroxaban is a new anti-coagulant with a proven safety profile.

The INVICTUS clinical trial in RHD atrial fibrillation