Usefulness of an isoproterenol infusion to differentiate a left atrial appendage thrombus in a patient with nonvalvular atrial fibrillation

Pacing Clin Electrophysiol. 2021 Jan;44(1):192-193. doi: 10.1111/pace.14033. Epub 2020 Aug 21.

Abstract

A 78-year-old male with a history of a cardiac embolic stroke due to persistent AF and cerebral bleeding (CHADS2 score 4, HAS-BLED score 4) was referred to our hospital to implant a left atrial appendage (LAA) closure (LAAC) device. A trans esophageal echocardiography was performed and a high echoic lesion that was difficult to differentiate the spontaneous echo contrast or thrombus was found in the LAA cavity. After isoproterenol infusion, a high echoic lesion disappeared and we confirmed that it was not an LAA thrombus. Successful LAAC device implantation was performed without any thromboembolic events.

Keywords: atrial fibrillation; isoproterenol; left atrial appendage thrombus.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Agonists / administration & dosage*
  • Aged
  • Atrial Appendage / diagnostic imaging*
  • Atrial Appendage / surgery*
  • Echocardiography, Transesophageal
  • Humans
  • Infusions, Intravenous
  • Isoproterenol / administration & dosage*
  • Magnetic Resonance Imaging
  • Male
  • Septal Occluder Device*

Substances

  • Adrenergic beta-Agonists
  • Isoproterenol