Key result
Ablation, cardioversion, and amiodarone restore sinus rhythm and ventricular function in invasive cardiac lipoma.
Why the study?
Primary cardiac lipomas are typically asymptomatic, but rare invasive variants can infiltrate the myocardium, generate significant arrhythmogenic substrate, and present unique diagnostic and therapeutic challenges.
Case Report (n=1)
Invasive cardiac lipomas in adolescents can create complex arrhythmogenic substrates causing refractory atrial flutter and ventricular dysfunction, requiring multidisciplinary management combining partial debulking, targeted ablation, and antiarrhythmic therapy with amiodarone.
Answers are grounded in this paper and cite their sources.
Invasive cardiac lipomas may underlie atrial flutter in adolescents; hypothesis-generating for arrhythmogenic tumor management and leaves prospective validation open.
BACKGROUND: Primary cardiac tumors are rare, with lipomas comprising ∼10% of benign cases. Although typically asymptomatic, invasive variants may infiltrate myocardium and generate significant arrhythmogenic substrate. CASE SUMMARY: A 14-year-old previously healthy male patient presented with atrial flutter and was found to have a large, infiltrative lipomatous mass involving the right atrium, right ventricle, and tricuspid valve. Biopsy and partial debulking confirmed invasive cardiac lipoma, but complete excision was precluded by extensive myocardial infiltration. Despite antiarrhythmic therapy, he developed recurrent atrial flutter and ventricular dysfunction. Electrophysiology study identified a cavotricuspid isthmus-dependent flutter that was successfully ablated; however, a second tumor-associated circuit was not amenable to ablation because of anatomical barriers. Sinus rhythm was restored with cardioversion and amiodarone with subsequent recovery of ventricular function. DISCUSSION: Invasive cardiac lipomas present unique diagnostic and therapeutic challenges, often requiring multimodal imaging, multidisciplinary management, aggressive rhythm control, and consideration of cardiac transplantation in select patients.
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Damera et al. (2026) conducted a case report in Invasive cardiac lipoma with atrial flutter (n=1). Partial surgical debulking, cavotricuspid isthmus catheter ablation, cardioversion, and amiodarone was evaluated on Sinus rhythm restoration and recovery of ventricular function. Catheter ablation, cardioversion, and amiodarone restored sinus rhythm and ventricular function in a 14-year-old male with atrial flutter from an unresectable invasive cardiac lipoma.
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