#Atrial flutter ablation indications trial
#Atrial flutter ablation indications series

Effusive constrictive pericarditis is a relatively rare diagnosis with only case series available in the literature. The diagnosis of effusive constriction was made after this patient showed evidence of persistently elevated right atrial pressure after intrapericardial pressure was normalized using pericardiocentesis. The patient is suffering from effusive constrictive pericarditis secondary to his post procedural pericardial effusion.

#Atrial flutter ablation indications trial

Trial of colchicine and nonsteroidal anti-inflammatory drugs for 3 months. Labs at the time of repeat TTE showed an elevated C-reactive protein.įigure 1: ECG at presentation in the outpatient clinic A repeat TTE was performed (Figure 4A-F) showing significant septal bounce, continued inflow velocity variation across the tricuspid and mitral valve, and IVC plethora. After the pericardiocentesis, the patient had only minimal improvement in his shortness of breath. Given his symptoms and TTE findings, the patient was taken for pericardiocentesis where 500 mL of bloody pericardial fluid were removed. A transthoracic echocardiogram (TTE) was performed showing a large, circumferential pericardial effusion, an inferior vena cava (IVC) diameter of 3.4cm which collapsed <50% with inspiration, and significant variation of inflow velocities across the tricuspid and mitral valves during the respiratory cycle (Figure 3A-F). Chest X-ray performed in the office was significant for enlarged cardiac silhouette and loss of the normal cardiac contour (Figure 2). Electrocardiogram showed normal sinus rhythm with occasional premature ventricular contractions (Figure 1). Physical exam revealed jugular venous distension but was otherwise normal. Medications include atorvastatin, aspirin, losartan, hydrochlorothiazide, metoprolol, dabigatran and HAART. His past medical history is significant for atrial flutter, non-ischemic cardiomyopathy (most recent left ventricular ejection fraction measured at 35%), hypertension, human immunodeficiency virus on highly active antiretroviral therapy (HAART), mild intermittent asthma and mild cognitive impairment. A 57-year-old male patient presents to the outpatient clinic complaining of chest pain and shortness of breath after an atrial flutter ablation 10 days prior to his visit.