PMC9171008_01
(A) Electrocardiogram showing atrial fibrillation with a rapid rate. (B) Transesophageal echocardiography showing spontaneous echo contrast (SEC) in left atrium and atrial appendage. (C) Abdominal CT scan with intravenous contrast shows infarctions (arrows) in the middle right and (D) Inferior left renal parenchyma and the inferior aspect of the spleen.
fcvm-09-879322-g0001.jpg
PMC9171008_01_fcvm-09-879322-g0001.jpg
F1
A physical examination revealed that the heart rhythm was irregular, and the ECG showed atrial fibrillation (AF) with a rapid ventricular rate(Figure 1A). Additionally, multiple infarcts were detected in both kidneys and spleen, but no obvious thrombosis in the renal artery and splenic artery (Figures 1C,D). Transesophageal echocardiography (TEE) was performed for suspected intracardiac thrombus formation; there was no intracardiac thrombus, but a severe spontaneous echo contrast (SEC) in both atrium and atrial appendage (Figure 1B).
(A) 3D modeling and substrate mapping of left atrium. (B) Catheter ablation at pulmonary veins, left atrium roof, and mitral isthmus. (C,D) Intracardiac echocardiography image of left atrial appendage (LAA) before or after LAA occlusion. (E,F) Fluoroscopy image of left atrial appendage (LAA) before or after LAA occlusion.
fcvm-09-879322-g0002.jpg
PMC9171008_01_fcvm-09-879322-g0002.jpg
F2
After a combination of ablation (Figures 2A,B) and left atrial appendage occlusion (LAAO) (Figures 2C-F) as a "One-stop" procedure, the patient restored sinus rhythm.
(A) Coronary artery CT angiography showing no protruding device-related thrombus and peri-device leak. (B) Renal artery CT angiography showing no new onset infarction.
fcvm-09-879322-g0003.jpg
PMC9171008_01_fcvm-09-879322-g0003.jpg
F3
Coronary artery CT angiography showed no protruding thrombi around the occlusion device and peri-device leak (Figure 3A). Renal artery CT angiography showed no new-onset infarction, the range of old infarcted lesions got smaller, and the margin of renal and splenic infarction got irregular (Figure 3B).