case_images: PMC8558795_01
case_images: High ventricular response atrial fibrillation (AF) on admission electrocardiogram. Patient's electrocardiogram on admission showed AF with a high ventricular response and diffuse T-waves abnormalities. Electrocardiogram paper speed: 25 mm/s.
case_images: 10.1177_2050313X211056419-fig1.jpg
case_images: PMC8558795_01_10.1177_2050313X211056419-fig1.jpg
case_images: fig1-2050313X211056419
case_images: Blood pressure was in the normal range, while electrocardiogram (ECG) showed high ventricular rate AF (Figure 1).
case_images: Left atrial appendage (LAA) thrombus on trans-oesophageal echocardiogram (TOE). TOE performed during hospital stay showed a mobile thrombus (4 mm x 4 mm) floating in the center of LAA (red arrow), contraindicating electrical cardioversion.
case_images: 10.1177_2050313X211056419-fig2.jpg
case_images: PMC8558795_01_10.1177_2050313X211056419-fig2.jpg
case_images: fig2-2050313X211056419
case_images: Preliminary TOE revealed severe LAA smoke effect, low LAA velocity (<20 cm/s), and a mobile floating thrombus (4 mm x 4 mm) in the center of LAA, contraindicating electrical cardioversion (Figure 2).