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A case of a 70 year old female with permanent atrial fibrillation and a history of stroke is presented. Echocardiography showed the presence of an oval mass in the left atrium which suggested thrombus or atrial myxoma. The patient underwent urgent cardiac surgery during which a long thrombus, originating from the left atrial appendage, was successfully removed.

Atrial fibrillation is the most common tachyarrhythmia after coronary artery bypass grafting. The etiology of this arrhythmia and factors responsible for its genesis are unclear. The aim of this study was to compare the frequency of AF in patients undergoing coronary artery bypass grafting without the use of cardiopulmonary bypass (CPB) with those undergoing CABG using standard CPB. The study population consisted of 325 patients who underwent coronary artery bypass grafting between June 2000 and December 2001 (mean age 60.02, range 38-83 years, 242 males). Each patient had continuous ECG monitoring since the operation to the third postoperative day. AF occurred in 100 of 325 patients (30.76%). Patients were divided into two groups according to the presence (group A-100 patients) or absence (group B-100 patients) of post-CABG AF. Patients in both groups were compared. Intraoperative variables were used to compare the two groups. Patients with AF were significantly older (66.04 +/- 7.88 vs. 60.49 +/- 9.74 p = 0.0001). There was no statistically significant difference in the incidence of atrial fibrillation between the patients after coronary artery bypass grafting procedures, performed with or without cardiopulmonary bypass.