• Lucrezia Pisanu, Nicola Baio, Francesco Rocco Bertuccio, Vittorio Chino, Valentina Ferroni, Ilaria Giana, Simone Montini, Marianna Russo, Alessandro Cascina, Valentina Conio, Giulia Accordino, and Angelo Guido Corsico.
• Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy. Electronic address: lucrezia.pisanu01@universitadipavia.it.
• Chest. 2024 Aug 1; 166 (2): e35e39e35-e39.

AbstractA 41-year-old man who currently smokes with previous sporadic use of cocaine and cannabinoids was admitted at the hospital suffering from hemoptysis which had developed 4 days before. The patient was on anticoagulant therapy with rivaroxaban due to paroxysmal atrial fibrillation diagnosed in 2018, for which he had undergone pulmonary vein electrical isolation by radiofrequency and ablation of cavotricuspid isthmus in January 2019. The procedure was completed in July 2019. Treatment with flecainide was introduced due to recurrences of atrial fibrillation. In February 2021, a new attempt at ablation was performed by electrical isolation of the left atrial posterior wall. The latest cardiologic checkup documented an echocardiographic framework of mild left atrial dilatation and normal-sized right ventricle with longitudinal shortening index at the lower limits, and a recurrence of asymptomatic atrial fibrillation at Holter ECG (March 2022).Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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