Paroxysmal atrial fibrillation due to left atrial appendage herniation and review of the literature

Misthos, Panagiotis; Neofotistos, Kostas; Drosos, Polivios; Kokotsakis, John; Lioulias, Achilleas

doi:10.1016/j.ijcard.2007.12.045

Cited by 7 publications

(14 citation statements)

References 20 publications

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“…CPDs are difficult to diagnose. Echocardiography and CT are the most common methods used to evaluate cardiac and thoracic abnormalities; however, pericardial defects may go unrecognized for years, as in this case [ 1 ]. Magnetic resonance imaging (MRI) has been reported to be superior to echocardiography [ 6 ], but cardiac MRI is still only applicable to a limited set of lesions.…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between AF and CPD is not well understood. Herniated LA appendages have been suggested to be a cause of paroxysmal AF [ 1 ]. Furthermore, enlargement of the LA and LA appendages due to herniation, as in our patient, may contribute to the development of persistent AF, and may even be its cause [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several methods have been proposed for the treatment of CPD, including LA appendectomy, extension of the pericardium to reduce incarceration, primary closure, and patch closure using synthetic materials [ 1 , 8 , 9 ]. However, no consensus currently exists regarding therapeutic options for CPD due to the small number of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Occasionally, these defects may cause symptoms such as chest pain, dyspnea, arrhythmias, syncope, and even sudden death. Arrhythmias, including atrial fibrillation (AF), are uncommonly found in cases of CPD [ 1 ]. Herein, we report the case of a patient with persistent AF associated with a CPD and herniation of an enlarged left atrial (LA) appendage.…”

Section: Case Reportmentioning

confidence: 99%

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Persistent Atrial Fibrillation Related to a Congenital Pericardial Defect and Left Atrial Appendage Herniation

Lee

Jeong

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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Congenital pericardial defects (CPDs) are infrequent anomalies that are usually asymptomatic and are discovered incidentally during unrelated interventions. Here we report the case of a CPD with herniation of an enlarged left atrial appendage identified during total thoracoscopic ablation (TTA) for persistent atrial fibrillation (AF). The persistent AF was successfully treated with a hybrid procedure, in which TTA was followed by an electrophysiological study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Persistent Atrial Fibrillation Related to a Congenital Pericardial Defect and Left Atrial Appendage Herniation

Lee

Jeong

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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“…This showed a continuous left-to-right flow with a peak systolic velocity of 2.2 m/s, reflecting a high systolic pressure gradient between the two atrial chambers (19 mmHg, normal maximal value of 10 mmHg, Boon, 2011). As reported in humans (Misthos et al, 2009) and in an 8-year-old Golden retriever (Schwarz et al, 2005), auricular herniation can be associated with supraventricular arrhythmias including atrial fibrillation, independent of the LA size. Nevertheless, the marked LA dilation secondary to mitral valve regurgitation may also have contributed to such tachyarrhythmia.…”

Section: Discussionmentioning

confidence: 54%

Antemortem diagnosis of a left auricular appendage herniation through a partial pericardial defect in a dog with degenerative mitral valve disease

Misbach

Pey

Gouni

et al. 2016

SAT

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A 14-year-old neutered male crossbreed dog was presented for weakness, cough and weight loss. Cardiac auscultation revealed tachycardia, arrhythmia and a grade V/VI left apical systolic heart murmur. Thoracic radiographs showed a large homogeneous soft tissue opacity in close contact with the cardiac silhouette in the left cranioventral mediastinum. Cardiac evaluation showed atrial fibrillation, degenerative mitral valve disease and a dilated left auricular appendage outside the pericardium consistent with herniation through a partial pericardial defect. Seven months after diagnosis, an atrial septal defect secondary to acquired atrial septal rupture was identified. The dog was euthanized thirteen months after initial presentation because of unresponsive clinical signs of congestive heart failure.

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Surgical correction of left auricular aneurysm herniation through a pericardial defect in a dog with atrial fibrillation and mitral valve disease

Freire

Conversy

Lasalle³

et al. 2022

Vet Record Case Reports

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Pericardial defect is a rare condition, with risk of cardiac chamber strangulation or incarceration. Surgical correction is recommended when clinical signs are unmanageable and to decrease the risk of thromboemboli. A 15-year-old, 4.1-kg, spayed female Shih Tzu dog presented to the hospital with a 6-month history of weakness and syncope episodes. The dog had been diagnosed with degenerative mitral valve disease 9 years earlier. Thoracic radiographs, echocardiography and computed tomography indicated a left auricular herniation through a pericardial defect. Clinical signs were temporarily controlled with pimobendan, benazepril and clopidogrel, until the syncope episodes returned along with atrial fibrillation (unresponsive to oral digoxin). Surgical correction (auriculectomy and partial pericardiectomy) was performed via thoracotomy. Atrial fibrillation reverted to normal sinus rhythm following surgery and recovery was uneventful. The patient survived, arrhythmia-free, for 25 months postoperatively. Syncope episodes never resolved.

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Paroxysmal atrial fibrillation due to left atrial appendage herniation and review of the literature

Cited by 7 publications

References 20 publications

Persistent Atrial Fibrillation Related to a Congenital Pericardial Defect and Left Atrial Appendage Herniation

Persistent Atrial Fibrillation Related to a Congenital Pericardial Defect and Left Atrial Appendage Herniation

Antemortem diagnosis of a left auricular appendage herniation through a partial pericardial defect in a dog with degenerative mitral valve disease

Surgical correction of left auricular aneurysm herniation through a pericardial defect in a dog with atrial fibrillation and mitral valve disease

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