Left Atrial Appendage Closure and the Figure-of-Eight Artifact

Atrial Appendage/pathology; Echocardiography

After percutaneous left atrial appendage (LAA) closure with the Amplatzer cardiac plug (ACP), an intriguing image in the shape of the number eight (figure-of-eight) is frequently observed on electrocardiography. This phenomenon is an image artifact that results from an interaction between the metal mesh of the ACP and the ultrasound waves¹. This finding should not be interpreted as a sign of incorrect ACP implantation.

Figure 1
Echocardiography findings for a 72-year-old female patient who underwent percutaneous LAA closure with the ACP. (A) Transthoracic echocardiographic image in the 5-chamber apical plane with the figure-of-eight image (arrow) in the left atrium (LA); (B) Increased anterior inclination of the transducer and visualization of the figure-of-eight; (C) Transthoracic echocardiographic image in the 3-chamber parasternal plane; (D) Transesophageal echocardiographic image with the figure-of-eight in the 5° projection (left), but not in the 95° projection (right) of the LAA.

• Study Association
  his study is not associated with any thesis or dissertation work.
• Author contributions
  Conception and design of the research, Acquisition of data, Analysis and interpretation of the data, Statistical analysis, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Barberato SH.
• Sources of Funding
  There were no external funding sources for this study.

Reference

• ¹
  Bertrand PB, Grieten L, De Meester P, Verbrugge FH, Mullens W, Verhaert D et al. Relevance of the figure-of-eight artifact on echocardiography after percutaneous left atrial appendage closure with the Amplatzer cardiac plug. J Am Soc Echocardiogr. 2014;27(3):323-8.e1.

Publication Dates

• Publication in this collection
  Aug 2014

History

• Received
  01 June 2014
• Reviewed
  13 June 2014
• Accepted
  13 June 2014