Giant Multiperforated Atrial Septal Aneurysm in a Patient with Paroxysmal Atrial Fibrillation

With the widespread use of transoesophageal echocardiography, atrial septal aneurysm (ASA) is more frequently recognized. Diagnostic criteria, however, remain arbitrary. A meticulous search for interatrial shunting (most often patent foramen ovale (PFO)) and associated cardiac diseases is important. ASA is considered a risk factor for cardioembolism, especially in association with PFO. We describe a patient with a giant multiperforated ASA presenting with refractory paroxysmal atrial fibrillation.