case_images: PMC7537681_01
case_images: Electrocardiogram on presentation shows sinus rhythm, complete heart block with junctional escape rhythm.
case_images: CRIC2020-3825312.001.jpg
case_images: PMC7537681_01_CRIC2020-3825312.001.jpg
case_images: fig1
case_images: The electrocardiogram (ECG) demonstrated sinus rhythm, complete heart block with a junctional escape rhythm (Figure 1).
case_images: Chest X-ray single view with right jugular transvenous pacing wire with lead terminating in the right ventricle. There is a loop of the transvenous pacing wire seen within the right atrium.
case_images: CRIC2020-3825312.002.jpg
case_images: PMC7537681_01_CRIC2020-3825312.002.jpg
case_images: fig2
case_images: Chest X-ray showed looping of the lead in the right atrium while pacing the right ventricular apex (Figure 2).
case_images: Apical four chamber from the transthoracic echocardiogram demonstrating a mass in the right atrium approximately 3-4 cm in size involving the interatrial septum.
case_images: CRIC2020-3825312.003.jpg
case_images: PMC7537681_01_CRIC2020-3825312.003.jpg
case_images: fig3
case_images: Transthoracic echocardiography revealed a hyperechoic dense structure in the right atrium (Figure 3).
case_images: Four chamber view from the cardiac computed tomography angiogram demonstrating the mass invading the interatrial septum and inlet ventricular septum, and extending into the tricuspid annulus as well.
case_images: CRIC2020-3825312.004.jpg
case_images: PMC7537681_01_CRIC2020-3825312.004.jpg
case_images: fig4
case_images: Therefore, cardiac computed topography angiography (CCTA) was performed and characterized the right atrial mass measuring 6.6 x 4.8 cm with Hounsfield units similar to myocardium without vascularization (Figure 4).