LIPOMATOUS HYPERTROPHY OF THE INTERATRIAL SEPTUM - A BENIGN HEART ANOMALY CAUSING UNEXPECTED PROBLEM IN ELECTROPHYSIOLOGY (CASE REPORT).

Lipomatous Hypertrophy of the Interatrial Septum (LHIS) is an unusual and benign condition characterized by the excessive deposition of adipose tissue in the interatrial septum, which is most often detected as an incidental finding on echocardiography. The classic finding is a homogenous, bi-lobed configuration of the interatrial septum with sparing of the fossa ovalis. LHIS has been associated with various atrial arrhythmias, including multifocal atrial tachycardia, multiple premature atrial contractions, atrial fibrillation and rarely sudden death. The prevalence of LHIS is estimated to be between 1-8%. The incidence increases with age, body mass and chronic corticosteroid therapy. There may be a higher incidence in women. Here the authors describe a case report of a 73 year-old obese female who visited the cardiology department for planned cryoablation of paroxysmal atrial fibrillation. Difficulties raised during transseptal punction, a bidimensional tranthoracic echocardiography (TTE) showed the typical findings of LHIS. A 73 year-old asymptomatic woman was found to have an incidental cardiac mass, TTE findings were consistent with lipomatous hypertrophy of the interatrial septum. Given the characteristic appearance on TTE, biopsy or surgery was not indicated, the procedure of cryoablation has been stopped and the patient was managed conservatively.