Paradoxical Response of Giant Left Atrial Appendage Aneurysm after Catheter Ablation of Atrial Fibrillation

Abstract

A giant left atrial appendage (LAA) aneurysm is a very rare cardiac anomaly, and associated with the supraventricular arrhythmia including atrial fibrillation (AF) (1-3). Furthermore, the giant LAA aneurysm may be the main source of thrombosis in patients with AF (1-3). With technical developments of catheter ablation, the percutaneous electrical isolation of cardiac arrhythmogenic substrates has been considered as the effective strategy for management of drug-refractory AF (4). Additionally, Hof et al. (5) reported that a patient with AF and giant LAA aneurysm could be successfully treated by percutaneous pulmonary vein antrum isolation. Echocardiography is the first line imaging technique to detect the giant LAA aneurysm (2). Especially transesophageal echocardiography (TEE) allows clear visualization of the LAA, and can be effective for the diagnosis of giant LAA aneurysm and thrombi. However, TEE may provide a relatively narrow field of view in the delineation of entire parts of giant LAA aneurysm (2). The role of cardiac magnetic resonance (CMR) has been emphasized in the comprehensive evaluation of cardiac anatomy, function, and This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received: May 9, 2016 Revised: June 13, 2016 Accepted: June 14, 2016