Investigative Magnetic Resonance Imaging  2016;20(2):132-135

doi:10.13104/imri.2016.20.2.132

Paradoxical Response of Giant Left Atrial Appendage Aneurysm after Catheter Ablation of Atrial Fibrillation.

Jee Won CHUNG 1 ; Jaemin SHIM ; Wan Joo SHIM ; Young Hoon KIM ; Sung Ho HWANG

Affiliations

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Keywords

Left atrial appendage; Atrial fibrillation; Catheter ablation; Magnetic resonance imaging; Echocardiography

Country

Republic of Korea

Language

English

Abstract

We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.