Left atrium perforation with lung injury after catheter ablation.

Left atrial perforation is a known complication following pulmonary vein catheter ablation. Our case of a 62-year-old female underwent urgent surgery for repair of left atrium perforation with left pleural effusion as a late complication after multiple transcatheter radiofrequency pulmonary vein ablations for persistent atrial fibrillation.

Multiple Spontaneous Coronary Artery Dissections: An Uncommon Cause of Acute Coronary Syndrome in a Syrian Refugee.

Spontaneous coronary artery dissection is an uncommon nonatherosclerotic cause of acute coronary syndrome. It usually occurs in young women and is often associated with fibromuscular dysplasia, connective tissue diseases, and pregnancy or postpartum states. We present a case of a Syrian woman with a history of grand multiparity and recent miscarriage who presented with non-ST-elevation myocardial infarction and was found to have multivessel spontaneous coronary artery dissection and severe left ventricular dysfunction.

Changes in Left Atrial Appendage Dimensions Following Volume Loading During Percutaneous Left Atrial Appendage Closure.

Objectives: This study sought to determine whether volume loading alters the left atrial appendage (LAA) dimensions in patients undergoing percutaneous LAA closure.

Background: Percutaneous LAA closure is increasingly performed in patients with atrial fibrillation and contraindications to anticoagulation, to lower their stroke and systemic embolism risk. The safety and efficacy of LAA closure relies on accurate device sizing, which necessitates accurate measurement of LAA dimensions.

Cardiac CT angiography for device surveillance after endovascular left atrial appendage closure.

Aims: Left atrial appendage (LAA) device imaging after endovascular closure is important to assess for device thrombus, residual leak, positioning, surrounding structures, and pericardial effusion. Cardiac CT angiography (CCTA) is well suited to assess these non-invasively.

Methods And Results: We report our consecutive series of non-valvular atrial fibrillation patients who underwent CCTA post-LAA closure with Amplatzer Cardiac Plug (ACP), Amulet (second generation ACP), or WATCHMAN devices.

Unnecessary shock from an implantable cardioverter-defibrillator following transcutaneous pacing.

As the population ages and cardiovascular disease becomes more prevalent, an increasing number of patients are receiving implantable cardioverter-defibrillators (ICDs). When these patients present to the emergency department, it is imperative that physicians are not only aware of the possible underlying medical issues that may have precipitated their admission but should also have a good understanding of the potential interactions that any medical intervention may have on the patient's device. We discuss a case in which a patient known to have an ICD in situ was transcutaneously paced for the management of bradycardia, leading to an unnecessary shock.