TY - JOUR
T1 - Left atrial appendage dysfunction in a patient with premature ventricular contractions - A risk factor for stroke?
AU - Patel, Sandeep M.
AU - Ackerman, Michael J.
AU - Asirvatham, Samuel J.
PY - 2013
Y1 - 2013
N2 - A 16-year-old female with ventricular dysfunction and frequent ventricular arrhythmia presented with a cardioembolic stroke. Prior electrophysiology study and ablation was performed for ventricular tachycardia (VT). For remaining ventricular ectopy, the patient was maintained on carvedilol and mexiletine. After one year on this regimen, she presented with an acute stroke. Transesophageal echocardiography revealed no evidence of an intracardiac or ventricular thrombus but demonstrated markedly decreased left atrial appendage (LAA) flow velocity worsened during frequent premature ventricular contractions (PVC). In the absence of atrial fibrillation (AF), the LAA dysfunction was considered secondary to the frequent PVCs and was thought to be the underlying cause for the stroke. We present this case to highlight a potential under recognized association between LAA dysfunction and ventricular arrhythmia, similar to that observed with atrioventricular dyssynchronous pacing.
AB - A 16-year-old female with ventricular dysfunction and frequent ventricular arrhythmia presented with a cardioembolic stroke. Prior electrophysiology study and ablation was performed for ventricular tachycardia (VT). For remaining ventricular ectopy, the patient was maintained on carvedilol and mexiletine. After one year on this regimen, she presented with an acute stroke. Transesophageal echocardiography revealed no evidence of an intracardiac or ventricular thrombus but demonstrated markedly decreased left atrial appendage (LAA) flow velocity worsened during frequent premature ventricular contractions (PVC). In the absence of atrial fibrillation (AF), the LAA dysfunction was considered secondary to the frequent PVCs and was thought to be the underlying cause for the stroke. We present this case to highlight a potential under recognized association between LAA dysfunction and ventricular arrhythmia, similar to that observed with atrioventricular dyssynchronous pacing.
KW - Left atrial appendage
KW - Noncompaction cardiomyopathy
KW - PVC
KW - Risk
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=84881032887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84881032887&partnerID=8YFLogxK
U2 - 10.1016/S0972-6292(16)30647-7
DO - 10.1016/S0972-6292(16)30647-7
M3 - Article
AN - SCOPUS:84881032887
SN - 0972-6292
VL - 13
SP - 136
EP - 141
JO - Indian Pacing and Electrophysiology Journal
JF - Indian Pacing and Electrophysiology Journal
IS - 4
ER -