Rapid Growth of Left Atrial Myxoma after Radiofrequency Ablation

Atrial myxoma is the most common benign tumor of the heart, but its appearance after radiofrequency ablation is very rare. We report a case in which an asymptomatic, rapidly growing cardiac myxoma arose in the left atrium after radiofrequency ablation. Two months after the procedure, cardiovascular magnetic resonance, performed to evaluate the right ventricular anatomy, revealed a 10 × 10-mm mass (assumed to be a thrombus) attached to the patient''s left atrial septum. Three months later, transthoracic echocardiography revealed a larger mass, and the patient was diagnosed with myxoma. Two days later, a 20 × 20-mm myxoma weighing 37 g was excised.To our knowledge, the appearance of an atrial myxoma after radiofrequency ablation has been reported only once before. Whether tumor development is related to such ablation or is merely a coincidence is uncertain, but myxomas have developed after other instances of cardiac trauma.Key words: Atrial fibrillation/prevention & control, catheter ablation/adverse effects, diagnosis, differential, echocardiography, transesophageal, echocardiography, transthoracic, heart neoplasms/ultrasonography, myxoma/diagnosis/surgery, pulmonary veinsRadiofrequency ablation (RFA) is an effective therapy for symptomatic patients with atrial fibrillation.¹ The reported complication rate after RFA is 3.9% to 22%,² including thromboembolism in 2% and an early mortality rate of 2% to 4% among all patients.³ Atrial myxoma is the most common cardiac tumor, but its appearance after RFA is very rare. We report a case in which an asymptomatic, rapidly growing cardiac myxoma arose in a patient''s left atrium after RFA.