Key result
Restoration of sinus rhythm by radiofrequency catheter ablation effectively improved right-sided heart failure and led to the near-complete disappearance of a massive right atrial thrombus.
Case Report (n=1)
No
In a patient with ARVC complicated by a massive right atrial thrombus and atrial flutter with 1:1 AV conduction, restoration of sinus rhythm via catheter ablation was essential for resolving heart failure and the thrombus.
Suggests possible benefit of ablation for right heart failure and atrial thrombus in ARVC; hypothesis-generating and should not yet change practice.
A 46-year-old man was admitted to our hospital for near syncope and palpitations. An electrocardiogram showed a common type of atrial flutter (AFL) with 1:1 atrioventricular conduction. Transthoracic echocardiography revealed a massive right atrial (RA) thrombus with a huge RA and right ventricle. The patient was diagnosed with arrhythmogenic right ventricular cardiomyopathy. It was difficult to control the heart rate with beta-blockers during AFL, which resulted in the deterioration of right-sided heart failure. The effect of anticoagulation therapy for the RA thrombus was also limited. Restoration to sinus rhythm by catheter ablation effectively improved the right-sided heart failure, and the massive RA thrombus eventually disappeared.
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Ito et al. (2016) conducted a case report in Arrhythmogenic right ventricular cardiomyopathy with right atrial thrombus and atrial flutter (n=1). Radiofrequency catheter ablation was evaluated on Resolution of right atrial thrombus and heart failure. Restoration of sinus rhythm by radiofrequency catheter ablation effectively improved right-sided heart failure and led to the near-complete disappearance of a massive right atrial thrombus.