Revolving thrombus within the left atrium at atrial fibrillation ablation

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• 作者：Dr. Mauro Toniolo M.D. (1) (2)
  Alejandro Estrada M.D. (1)
  David Filgueiras-Rama M.D. (1)
  Jos猫 L. Merino M.D. (1)
  
  1. Arrhythmia and Robotic Cardiac Electrophysiology Unit ; IdiPaz ; Hospital Universitario 鈥淟a Paz鈥? Madrid ; Spain
  2. Division of Cardiology ; University Hospital 鈥淪.Maria della Misericordia鈥? Udine ; Italy
  
• 关键词：Pulmonary vein isolation ; Transseptal puncture ; Thrombus ; Heparin ; Thromboembolic events ; Pulmonalvenenisolation ; Transseptale Punktion ; Thrombus ; Heparin ; Thrombembolischen
• 刊名：Herzschrittmachertherapie und Elektrophysiologie
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：26
• 期：1
• 页码：54-55
• 全文大小：235 KB
• 参考文献：1. January, CT, Wann, LS, Alpert, JS, Calkins, H, Cigarroa, JE, Cleveland, JC, Conti, JB, Ellinor, PT, Ezekovitz, MD, Field, ME, Murray, KT, Sacco, RL, Stevenson, WG, Tchou, PJ, Tracy, CM, Yancy, CV (2014) AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 64: pp. e1-e76 2014.03.022" target="_blank" title="It opens in new window">CrossRef
  2. Cappato, R, Calkins, H, Chen, SA, Davies, W, Iesaka, Y, Kalman, J, Kim, YH, Klein, G, Natale, A, Packer, D, Skanes, A, Ambrogi, F, Biganzoli, E (2010) Update worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol 3: pp. 32-38 CrossRef
  3. Demolin, JM, Eick, OJ, Munch, K, Koullick, E, Nakagawa, H, Wittkampf, FHM (2002) Soft thrombus formation in radiofrequency catheter ablation. Pacing Clin Electrophysiol 25: pp. 1219-1222 2.2002.01219.x" target="_blank" title="It opens in new window">CrossRef
  4. Wazni, O, Rossillo, A, Marrouche, NF, Saad, EB, Martin, DO, Bhargava, M, Bash, D, Beheiry, S, Wexman, M, Potenza, D, Pisano, E, Faneli, F, Bonso, A, Themistoclakis, S, Erciyes, D, Saliba, WI, Schweikert, RA, Brachmann, J, Raviele, A, Natale, A (2005) Embolic events and char formation during pulmonary vein isolation in patients with atrial fibrillation: impact of different anticoagulation regimens and importance of intracardiac echo imaging. J Cardiovasc Electrophysiol 16: pp. 576-581 2005.40480.x" target="_blank" title="It opens in new window">CrossRef
  5. Okuyama, Y, Kashiwase, K, Mizuno, H, Oka, T, Takeda, Y, Komatsu, S, Hirayama, A, Kodama, K (2006) Development of thrombus on a transseptal sheath in the left atrium during attempted electrical pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation. Europace 8: pp. 191-192 CrossRef
  6. Bruce, CJ, Friedman, PA, Narayan, O, Munger, TM, Hammill, SC, Packer, DL, Asirvatham, SJ (2008) Early heparinization decreases the incidence of left atrial thrombi detected by intracardiac echocardiography during radiofrequency ablation for atrial fibrillation. J Interv Card Electrophysiol 22: pp. 211-219 270-x" target="_blank" title="It opens in new window">CrossRef
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1435-1544

文摘

A 68-year-old man was referred for pulmonary vein (PV) isolation. Access to the left atrium was obtained via a single transseptal puncture. A heparin bolus was given immediately after puncture. Angiography of the left PV was performed. After the contrast wash-out, a contrasted longitudinal thrombus was shown revolving within the left atrium for several seconds before being expelled through the mitral and aortic valves. It is common practice in these procedures to administer an intravenous bolus of heparin immediately after the transseptal puncture. However, heparin has latency to become effective, and this can result in thromboembolic events.