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Thrombus development on a transseptal sheath in the right atrium before electrical pulmonary vein isolation

Nieves Romero-Rodriguez1, Alonso Pedrote, Eduardo Arana-Rueda

  • 1Arrhythmia Unit. Hospital Virgen del Rocio, Seville, Spain. niemed21@hotmail.com

Indian Pacing and Electrophysiology Journal
|February 14, 2008
PubMed

Insights

A thrombus on a transseptal sheath was identified in the right atrium during atrial fibrillation treatment. Intracardiac echocardiography likely prevented a major thromboembolic event.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Atrial fibrillation is a common arrhythmia requiring treatment.
  • Transseptal puncture is a key procedure for atrial fibrillation ablation.
  • Thromboembolic complications are a risk during cardiac procedures.

Purpose of the Study:

  • To report a case of thrombus formation on a transseptal sheath.
  • To highlight the utility of intracardiac echocardiography in identifying intraprocedural complications.
  • To emphasize the potential for preventing thromboembolic events.

Main Methods:

  • Case report of a patient undergoing circumferential pulmonary vein isolation.
  • Utilized intracardiac echocardiography for real-time imaging during the procedure.
  • Described the identification and management of an unexpected finding.

Main Results:

  • A thrombus was identified on the transseptal sheath within the right atrium prior to transseptal puncture.
  • Intracardiac echocardiography provided clear visualization of the thrombus.
  • The finding potentially averted a significant thromboembolic complication.

Conclusions:

  • Transseptal sheath thrombus is a rare but serious complication.
  • Intracardiac echocardiography is invaluable for detecting such intraprocedural risks.
  • Early detection and intervention can prevent major adverse events during atrial fibrillation ablation.

Keywords:
ablationintracardiac thrombusintracardiac ultrasoundpulmonary veinstroketransseptal catheterization

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