Korean Circ J.  2016 Jul;46(4):580-583. 10.4070/kcj.2016.46.4.580.

Conservative Management of Left Atrial Intramural Hematoma after Catheter Ablation

• Moradi B
• Oraii S
• Roshanali
• Ghorbanisharif A
• Mikaeili J
• Tahraei M

• KMID: 2344436
• DOI: http://doi.org/10.4070/kcj.2016.46.4.580

Abstract

Left atrial intramural hematoma is a very rare complication of radiofrequency ablation procedures. A patient with tachyarrhythmia underwent radiofrequency catheter ablation. Echocardiography performed the following morning showed a large mass in the left atrium, suggestive of intramural hematoma formation. The patient was in a stable condition; therefore, it was decided that follow-up should be conservative and her anticoagulation therapy was continued. The size of the hematoma decreased significantly over the following 50 days. This case highlights a rare complication of a complex catheter ablation procedure in the left atrium that was managed via a noninvasive approach, with which all interventionists should be familiar.

Keyword

Heart atria; Radiofrequency; Ablation; Hematoma; Complications

MeSH Terms

Catheter Ablation*
Catheters*
Echocardiography
Follow-Up Studies
Heart Atria
Hematoma*
Humans
Tachycardia

Figure

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  Fig. 1 A 4-chamber view of the transesophagial echocardiograph showing a large multi-loculated mass occupying most of the left atrial space (arrows) and partially obstructing the left ventricular inflow

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  Fig. 2 A computed tomographic angiography image showing a homogeneous non-enhancing intramural mass located in the posterosuperior left atrial wall (arrows).

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  Fig. 3 A follow-up three-dimensional transesophagial echocardiograph (4-chamber view; in diastole) taken 50 days after discharge showing significant resolution of the left atrial hematoma (arrow).

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