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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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Published on: February 26, 2013

Right atrial appendage: forgotten part of the heart in atrial fibrillation

Orhan Ozer1, Ibrahim Sari, Vedat Davutoglu

  • 1Department of Cardiology, School of Medicine, Gaziantep University, Gaziantep, Turkey. oozer@gantep.edu.tr

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|October 9, 2008
PubMed

Insights

Atrial fibrillation (AF) can lead to thrombus formation, most commonly in the left atrial appendage. This case highlights the rare but dangerous possibility of right atrial appendage thrombus, even when the left side is clear.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) is a prevalent arrhythmia linked to increased risk of thromboembolism.
  • Cardioversion is a common treatment for AF, necessitating pre-procedural assessment for thrombus.
  • Thrombus typically forms in the left atrial appendage (LAA) and left atrium (LA).

Observation:

  • Routine transesophageal echocardiography for AF often focuses on the LA and LAA.
  • A rare case of thrombus exclusively in the right atrial appendage (RAA) was identified.
  • The left atrium and left atrial appendage were free of thrombus in this patient.

Findings:

  • Right atrial appendage (RAA) thrombus, though uncommon, poses an embolic risk.
  • Screening for RAA thrombus is crucial, even when LA and LAA appear unaffected.
  • This case underscores the potential for isolated RAA thrombus in AF patients.

Implications:

  • Echocardiographic protocols for AF may need revision to include thorough RAA evaluation.
  • Early detection of RAA thrombus can prevent potentially severe embolic events.
  • Understanding rare thrombus locations improves risk stratification and patient management in AF.

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