References
  1. Fiorenzo G, Domenico C, Martina O, Marco S, Elisabetta T, Federico C, Carlo B, Giovanni G, Maria V, Roberto P, Franck H, Jean L. Radiofrequency Catheter Ablation of Atrial Fibrillation: A cause of Silent Thromboembolism? Magnetic Resonance Imaging Assessment of Cerebral Thromboembolism in Patients Undergoing Ablation of Atrial Fibrillation. Circularion 2010;17:1667-1673
  2. Suenari K, Hirao H, Ueda H. A proturding lesion on the previous pulmonary vein isolation line in case with paroxysmal atrial fibrillation. Europace 2015;17:837
  3. Kuroda Y, Minakata K, Yamazaki K, Sakaguchi H, Uehara K, Sakata R. A Giant Left Atrial Thrombus After Radiofrequency Catheter Ablation. Ann Thorac Surg. 2016;102:461
  4. Mugnai G, de Asmundis C, Ciconte G, Irfan G, Saitoh Y, Velagic V, Stroker E, Wauters K, Hunuk B, Brugada P, Chierchia GB. Incidence and characteristics of complications in the setting of second-generation cryoballoon ablation: A large single-center study of 500 consecutive patients. Heart Rhythm 2015;12:1476-1482.
  5. Hisazaki K, Hasegawa K, Kaseno K, Miyazaki S, Amaya N, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. Endothelial damage and thromboembolic risk after pulmonary vein isolation using the latest ablation technologies: a comparison of the second-generation cryoballoon vs. contact force-sensing radiofrequency ablation. Heart Vessels 2019;34:509-516.
  6. Gurudevan SV, Shah H, Tolstrup K, Siegel R, Krishnan SC. Septal thrombus in the left atrium: is the left atrial septal pouch the culprit? JACC Cardiovasc Imaging 2010;3:1284-1286.
  7. Shimamoto K, Kawagoe T, Dai K, Inoue I. Thrombus in the left atrial septal pouch mimicking myxoma. J Clin Ultrasound 2014;42:185-188.
Figure Legend
Fig1 A,B,C
A,B A transesophageal echocardiography image of an ovoid mass 15 mm in diameter (arrows) at the anterior aspect of the right superior pulmonary vein antrum is shown.
C Contrast-enhanced computed tomography of location of the mass (red arrow) revealed that it occurred at the previous ablation site.
Fig2 A,B
A A red, soft mass was observed at the cranial aspect of the right upper pulmonary vein orifice, as seen in the preopereative examination.
B The mass had adhered to the previous ablation site and was easily removed. Its size was 15 × 12 mm.
Fig3
Hematoxylin Eosin statin of specimen from surgery is shown. Scale bar is shown right above in the picture.
Layers of organized thrombus were formed on endocardium and fibrin thrombi were above them. Part of endocardium was replaced with necrotic tissue and structure of muscle layer was collapsed. Epicardium consists loose collagen fibers with inflammatory cells and neocapillaries are formed.