When Hindsight Is 20/20

Abstract

Scarring from atrial ablation carries a risk of developing stiff left atrium syndrome, which can mimic mitral valve disease. We present a case of a 73-year-old man whose stiff left atrium syndrome came to light after percutaneous mitral valve repair. ( Level of Difficulty: Intermediate. )

Optimal stress testing for dynamic functional mitral regurgitation in patients with acute decompensated heart failure

“…In patients with decreased left atrial compliance, the left atrium cannot accommodate atrial filling from the right ventricular contraction and pulmonary veins, resulting in an accentuated V-wave (stiff left atrial syndrome). 23 One should consider both the left atrial compliance and MR when assessing the pulmonary capillary wedge pressure. When both elevated pulmonary capillary wedge pressure with a prominent V-wave and MR progression are observed during exercise stress, MR is likely to be a significant contributor to heart failure exacerbation.…”

Left atrial calcification on chest CT: atrial ablation replaces rheumatic heart disease as the most identified etiology

“…Left atrial calcification can predispose or manifest cardiac conditions, including mitral valvular disease, bradyarrhythmia, and "stiff left atrial syndrome", a hemodynamic manifestation of atrial diastolic dysfunction associated with radiofrequency ablation of the left atrium. Left atrial calcification and its associated conditions may have important clinical consequences, including sudden cardiac death, mortality after mitral valve replacement, recurrent atrial fibrillation, and congestive heart failure [17][18][19][20][21]. Although the clinical relationship between atrial calcification and stiff left atrial syndrome is uncertain, the rise in atrial ablation procedures and identification of subsequent stiff left atrial syndrome as a complication suggests a potential relationship and poses a disagreement from established view regarding left atrial calcifications [13,22,23].…”