Visual Abstract - Direct Thrombin Inhibitors Prevent Left Atrial Remodeling Associated With Heart Failure in Rats: 10.1016/j.jacbts.2016.05.002

• Oral direct anticoagulants such as DTIs, but not vitamin K antagonist, diminish the progression of atrial dilation associated with heart failure in a rat model.

• Prevention of atrial dilation by DTI is associated with decreased duration of atrial arrhythmia induced by burst pacing.

• DTI inhibits interstitial fibrosis, extracellular matrix remodeling, and hypertrophy of atrial myocardium.

• Plasma DTI concentrations inhibiting atrial remodeling are lower than those required for therapeutic anticoagulant activity.

• DTIs may be of interest to prevent the progression of atrial fibrillation substrate in addition to their anticoagulant activity.