Key result
LAAO fails to eliminate right atrial appendage thrombosis risk in chronic AF.
Why the study?
Right atrial appendage thrombosis is exceedingly rare, typically found incidentally on imaging, and carries a high thromboembolic risk.
Case Report (n=1)
Left atrial appendage occlusion devices do not eliminate the risk of right atrial appendage thrombosis, highlighting that atrial fibrillation is a biatrial disease.
Answers are grounded in this paper and cite their sources.
Incidental RAA thrombosis remains possible despite WATCHMAN; this case leaves open optimal surveillance and management strategies.
BACKGROUND: Right atrial appendage (RAA) thrombosis is exceedingly rare, is usually found incidentally on imaging, and carries a high thromboembolic risk. CASE SUMMARY: An 83-year-old man with chronic atrial fibrillation complicated by previous bleeding episodes on anticoagulation and managed most recently with a WATCHMAN device presented after a mechanical fall. Imaging work-up revealed a new incidental finding of RAA thrombosis. DISCUSSION: This case highlights an uncommon thrombotic finding and that atrial fibrillation is a biatrial disease. Occlusion of the left atrial appendage does not eliminate the risk of right-sided thrombosis. TAKE-HOME MESSAGES: Thromboembolic prevention in patients with chronic atrial fibrillation is challenging. Left atrial appendage occlusion devices, although effective, do not eliminate the risk of RAA thrombosis, as atrial fibrillation is a biatrial disease.
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Chamay et al. (2026) conducted a case report in Chronic atrial fibrillation (n=1). Left atrial appendage occlusion device (WATCHMAN) was evaluated on Right atrial appendage thrombosis. Left atrial appendage occlusion devices do not eliminate the risk of right atrial appendage thrombosis in patients with chronic atrial fibrillation, as demonstrated by this case.
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