Key result
Isoproterenol infusion successfully differentiated spontaneous echo contrast from a left atrial appendage thrombus, allowing for successful LAAC device implantation without thromboembolic events.
Why the study?
Does isoproterenol infusion help differentiate a left atrial appendage thrombus from spontaneous echo contrast in a patient with nonvalvular atrial fibrillation?
Case Report (n=1)
No
Does isoproterenol infusion help differentiate a left atrial appendage thrombus from spontaneous echo contrast in a patient with nonvalvular atrial fibrillation?
Answers are grounded in this paper and cite their sources.
Isoproterenol infusion during transesophageal echocardiography may be a useful technique to differentiate spontaneous echo contrast from a true thrombus in the left atrial appendage prior to closure device implantation.
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.
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Enomoto et al. (2020) conducted a case report in Nonvalvular atrial fibrillation (n=1). Isoproterenol infusion was evaluated on Differentiation of LAA thrombus from spontaneous echo contrast. Isoproterenol infusion successfully differentiated spontaneous echo contrast from a left atrial appendage thrombus, allowing for successful LAAC device implantation without thromboembolic events.
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