SWITCH: Apixaban vs Vitamin K in HM3

Inclusion Criteria:

* Participants will have HeartMate3 LVAD implanted \> 3 months before enrollment
* ≥ 18 years old
* Treated with WARFARIN SODIUM
* Participant must provide written informed consent prior to any clinical investigation related procedure
* In female participants of childbearing capability, not currently pregnant and on appropriate contraception

Exclusion Criteria:

* Participation in any other clinical investigation(s) involving a Mechanical Circulatory Support (MCS) device, or interventional investigation(s) likely to confound study results or affect study outcome
* Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results
* Known allergy to Apixaban
* Bridge to transplant
* Severe renal dysfunction Estimated Glomerular Filtration Rate (eGFR) \<20
* History of major bleeding event with subsequent reduction of INR goal to \< 1.8
* Apixaban dose reduction criteria (Age ≥80 years, weight ≤60 kg, creatinine ≥1.5 mg/dL)
* Aortic root thrombus