Transesophageal echocardiographic evidence of atrial fibrillation with systolic flow in the right atrial appendage and systolic reversal pulmonary flow in a patient with DDD permanent pacing

Echocardiography
Carlo Oneglia, Cesare Rusconi

Abstract

We report the case of a patient with atrial fibrillation on standard electrocardiogram who underwent transesophageal echocardiography to rule out presence of thrombi in heart cavities. Pulsed-wave Doppler investigation revealed multiphasic waves consistent with atrial fibrillation in the left atrial appendage, while in the right atrial appendage, a biphasic flow was registered after QRS depolarization. Some hypotheses are made about the origin of this signal.

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