Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Paradoxical Response of Giant Left Atrial Appendage Aneurysm after Catheter Ablation of Atrial Fibrillation

  • Chung, Jee Won (Department of Radiology, Korea University Anam Hospital) ;
  • Shim, Jaemin (Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital) ;
  • Shim, Wan Joo (Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital) ;
  • Kim, Young-Hoon (Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital) ;
  • Hwang, Sung Ho (Department of Radiology, Korea University Anam Hospital)
  • Received : 2016.05.09
  • Accepted : 2016.06.14
  • Published : 2016.06.30
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Abstract

We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.

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References

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