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The 'Cauliflower Heart': a case report of congenital bi-atrial aneurysms causing non-controllable arrhythmia
Fabienne Stoller1, Martin Glöckler1, Alexander Kadner2
1Center for Congenital Heart Disease, Department of Cardiology, Pediatric Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010 Bern, Switzerland.
Background:
Congenital aneurysms of the atrium are very rare malformations. Known complications are therapy-resistant arrhythmias. Different treatments such as medical therapy, electrophysiological ablation, and surgery have been proposed. However, there are no guidelines on treatment.
Case Summary:
We describe the case of a neonate with bi-atrial aneurysms causing atrial arrhythmia. Arrhythmia was first observed in the 28th week of gestation. Maternal digoxin treatment did not show any effect. After birth, bi-atrial aneurysms were diagnosed and determined as the probable cause of the atrial tachycardia and later of atrial flutter. Antiarrhythmic drug treatment was initiated. However, only frequency control could be achieved. At the age of 7 months, the patient underwent surgical resection. Since surgery, sinus rhythm is present.
Conclusion:
Atrial aneurysms are rare malformations, known complications are atrial arrhythmia. If medical treatment fails, surgery correction appears to be indicated going along with low operative risk and a high probability of successful termination of arrhythmia.
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