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Atrial fibrillation radiofrequency ablation is associated with a 2.6%–4.0% risk of acute complications. Left atrial (LA) intramural hematoma is an unusual complication of atrial arrhythmia radiofrequency ablation. All previously described patients presented with a masslike lesion of LA at the time of diagnosis. Because anticoagulation is usually required after LA ablation, early and accurate diagnosis is pivotal for management. We report a case of early-stage LA intramural hemorrhage, which presented with a cystlike lesion rather than a masslike lesion, and mimicked dilated coronary sinus with partial thrombosis. In this case, an accurate diagnosis was missed on the second day after the procedure, leading to enlargement of the hemorrhage. Proper diagnosis was reached on day 4, and the patient was stabilized after discontinuing anticoagulation. Follow-up echocardiography results showed that the hematoma resolved completely later.

heartrhythm case reports

Early-stage left atrial intramural hemorrhage mimicking partial coronary sinus thrombosis in a patient who received ablation for atrial tachyarrhythmias