Related Experiment Video
Updated: Jul 7, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
What to do with an atrial thrombus?
Rocío Carda1, Carlos Almería, Vera Lennie
1Laboratorio de Ecocardiografía, Instituto Cardiovascular, Hospital Clínico Universitario de San Carlos, C/Profesor Martín lagos s/n, 28040 Madrid, Spain. rocicarda@hotmail.com
Summary
An 84-year-old woman with a right atrial thrombus attached to a pacemaker lead experienced a fatal outcome despite successful percutaneous stenting. This case highlights the complexities of treating such rare cardiac thrombi.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- Right atrial thrombi are rare but serious cardiac conditions.
- Pacemaker leads can be a nidus for thrombus formation.
- Management of right atrial thrombi is often challenging due to patient comorbidities.
Observation:
- An 84-year-old female presented with a right atrial thrombus adherent to a pacemaker lead.
- Diagnosis was confirmed using transesophageal echocardiography.
- The patient was deemed high-risk for surgical intervention.
Findings:
- Percutaneous stenting was successfully performed as an alternative to surgery.
- Despite the technical success of the intervention, the patient experienced a fatal outcome.
- This underscores the potential risks associated with interventions in frail patients.
Implications:
- The case highlights the need for careful risk-benefit assessment in managing right atrial thrombi.
- Percutaneous interventions may be considered but do not negate the inherent risks.
- Further research into optimal treatment strategies for right atrial thrombi is warranted.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...