Key result
TEE-guided cardioversion successfully restores sinus rhythm in typical atrial flutter with cor triatriatum sinister.
Why the study?
Cor triatriatum sinister is a rare congenital anomaly infrequently identified in asymptomatic adults and its association with atrial arrhythmias remains uncertain.
Case Report (n=1)
Incidental nonobstructive cor triatriatum sinister presenting with atrial arrhythmias in adulthood can be managed conservatively with directed treatment of the arrhythmia rather than surgical correction.
Conservative arrhythmia management may suffice for incidental nonobstructive cor triatriatum sinister in adults; leaves open long-term recurrence risk.
BACKGROUND: Cor triatriatum sinister (CTS) is a rare congenital anomaly, infrequently identified in asymptomatic adults. CASE SUMMARY: A 64-year-old man presented with asymptomatic atrial flutter detected on routine electrocardiogram. Rate control was suboptimal, and because of unknown arrhythmia duration, transesophageal echocardiography (TEE) was performed before cardioversion. TEE excluded intracardiac thrombus and incidentally revealed a left atrial membrane. Cardiac magnetic resonance imaging confirmed nonobstructive CTS. The patient underwent successful TEE-guided electrical cardioversion and was discharged on anticoagulation. DISCUSSION: CTS has been associated with atrial arrhythmia, although causality remains uncertain, particularly when arrhythmia originates from the right atrium. This case highlights the role of multimodality imaging in identifying incidental congenital anomalies and guiding safe management. TAKE-HOME MESSAGES: Careful atrial evaluation during TEE may reveal incidental CTS. Distinguishing associations from causation is essential for appropriate management.
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Panjiyar et al. (2026) conducted a case report in Atrial flutter and Cor Triatriatum Sinister (n=1). TEE-guided synchronized electrical cardioversion was evaluated on Restoration of sinus rhythm. TEE-guided synchronized electrical cardioversion successfully restored sinus rhythm in a 64-year-old man with typical right atrial flutter and incidental nonobstructive cor triatriatum sinister.
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