DOT HeartMate 3 Study

Inclusion Criteria: * The patient has been implanted with HeartMate 3 LVAS * The patient is, at a minimum, 3 months post HeartMate 3 implant * The patient is stable, ambulatory, and has been discharged home * The patient provides written informed consent before any clinical investigation related procedure Exclusion Criteria: * Non-compliance with anticoagulation and antiplatelet medication, in the opinion of the investigator * Weight ≤ 60 kgs. or age ≥ 80 years * Poor kidney function with serum creatinine ≥ 221umol/L or creatinine clearance \< 0.042 mL/s, or the need for chronic renal replacement therapy * Total bilirubin \> 43 umol/L, shock liver, or biopsy-proven liver cirrhosis * Absence of an informed consent * Presence of any mechanical prosthetic valve or any ancillary circulatory assist device system (other than the HM3) * Recent history of cardioembolic stroke * Hemodynamically significant carotid arteries stenosis (documented by imaging investigation not older than 12 months) * Need for antiplatelet therapy for reasons other than LVAD therapy * Major HRAE event after HeartMate 3 index hospitalization discharge * Known history of hyper- or hypo- coagulable disorder * Anti-phospholipid syndrome positive patients with documented history of thrombotic/thromboembolic events * Known hypersensitivity or allergy to apixaban or aspirin * The patient is involved in another interventional study or any study that could potentially affect the functioning of the HM3 LVAD or the…