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Published on: February 26, 2013
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Left Atrial Posterior Wall Thrombus After Posterior Wall Ablation
Shourjo Chakravorty1, Sangeeta Shah1,2, Michael L Bernard2
1The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.
Ochsner Journal
|July 3, 2020
Summary
Posterior wall isolation for atrial fibrillation can rarely lead to left atrial thrombus. This case highlights the importance of considering patient-specific risk factors and potential imaging to prevent serious complications.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Case Reports
Background:
- Posterior wall isolation is a common treatment for recurrent atrial arrhythmia.
- Long-term effects on left atrial function and thrombus risk post-isolation are not well-established.
- Atrial fibrillation ablation aims for long-term freedom from arrhythmia.
Observation:
- A 67-year-old female developed a left atrial posterior wall thrombus 5 weeks after posterior wall isolation.
- The patient had multiple risk factors including hypertension, low ejection fraction, and mitral valve disease.
- The thrombus was detected before a third ablation attempt for left atrial tachycardia.
Findings:
- The patient received 3 weeks of anticoagulation, resolving the left atrial thrombus.
- Successful reisolation of the posterior wall was performed.
- The patient experienced no stroke or embolic complications.
Implications:
- This is the second reported case of left atrial posterior wall thrombus post-ablation.
- Specific patient risk factors may predispose to rare thrombus formation.
- Pre-ablation imaging may be beneficial in high-risk patients to prevent systemic embolization.
