Document Detail

Hybrid epicardial and endocardial catheter ablation in a patient with atrial fibrillation and suspicious left atrial thrombus.
MedLine Citation:
PMID:  19057085     Owner:  NLM     Status:  MEDLINE    
Patients with a left atrial (LA) thrombus are considered at risk of a serious thromboembolic event, and therefore endocardial radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is contraindicated. However, RFCA of AF is inevitable in some patients with highly symptomatic AF and suspicious LA masses resembling thrombus. A patient was treated who underwent hybrid epi- and endocardial RFCA for drug resistant, highly symptomatic, paroxysmal AF with a suspicious left atrial (LA) thrombus that was a lamellated, thickened, echogenic lesion attached to the LA anterior wall and resistant to anticoagulation. During RFCA, contact with the LA endocardium was minimized using hybrid epi- and endocardial ablation guided by computed tomography merged with 3-dimensional electroanatomical mapping (NavX). The patient has been free of AF without antiarrhythmic drugs for 6 months, therefore hybrid epi- and endocardial ablation may be an effective therapy for AF patients with a LA mass.
Jong-Il Choi; Hui-Nam Pak; Young-Hoon Kim
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-12-05
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-23     Completed Date:  2009-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  384-7     Citation Subset:  IM    
Korea University Cardiovascular Center, Seoul, Republic of Korea.
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MeSH Terms
Anticoagulants / therapeutic use
Atrial Fibrillation / surgery*
Catheter Ablation / methods*
Endocardium / surgery*
Heart Atria / surgery*
Pericardium / surgery*
Thromboembolism / prevention & control
Thrombosis / surgery*
Treatment Outcome
Warfarin / therapeutic use
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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