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. 2009 Feb 3;21(10):769–771. doi: 10.1002/clc.4960211015

Impairment of left atrial appendage function after spontaneous conversion of atrial flutter

Michael C Kontos 1,, Walter HJ Paulsen 1
PMCID: PMC6656282  PMID: 9789701

Abstract

This paper reports a patient in atrial flutter who spontaneously converted to sinus rhythm while undergoing a transesophageal echocardiogram. Atrial appendage flow velocities were noted to be significantly decreased after conversion to sinus rhythm. Spontaneous contrast also developed in the left atrium shortly after conversion. Spontaneous cardioversion may be associated with decreased mechanical activity of the left atrium and appendage, resulting in “stunning.” This provides a possible explanation for the occurrence of thromboembolic events in patients without apparent thrombus before cardioversion.

Keywords: atrial flutter, transesophageal echocardiogram

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