Usefulness of an isoproterenol infusion to differentiate a left atrial appendage thrombus in a patient with nonvalvular atrial fibrillation.
Yoshinari EnomotoHidehiko HaraKenji MakinoKeijiro NakamuraKaoru SugiMasao MoroiMasato NakamuraPublished in: Pacing and clinical electrophysiology : PACE (2020)
A 78-year-old male with a history of a cardiac embolic stroke due to persistent AF and cerebral bleeding (CHADS2 score 4, HAS-BLED score 4) was referred to our hospital to implant a left atrial appendage (LAA) closure (LAAC) device. A trans esophageal echocardiography was performed and a high echoic lesion that was difficult to differentiate the spontaneous echo contrast or thrombus was found in the LAA cavity. After isoproterenol infusion, a high echoic lesion disappeared and we confirmed that it was not an LAA thrombus. Successful LAAC device implantation was performed without any thromboembolic events.
Keyphrases
- atrial fibrillation
- left atrial appendage
- catheter ablation
- oral anticoagulants
- left atrial
- direct oral anticoagulants
- magnetic resonance
- left ventricular
- heart failure
- low dose
- percutaneous coronary intervention
- contrast enhanced
- computed tomography
- subarachnoid hemorrhage
- magnetic resonance imaging
- pulmonary hypertension
- case report
- emergency department
- diffusion weighted
- venous thromboembolism
- soft tissue
- blood brain barrier
- acute care
- mitral valve