As the left atrial volume is apparently dilated and a prosthetic valve implanted, the anticoagulation would be necessary even though LAA closure would minimize the risk of thromboembolism. Both drugs could not prevent aFib (atrial fibrillation) because of persistent mitral stenosis, Digoxin could control ventricular rate during aFib recurrences. Anyway both have potential adverse effects and need follow up.
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