Successful lysis of right and left heart thrombus by tissue plasminogen activator

Tissue plasminogen activator (t-PA) was administered to three patients with newly developed intracardiac thrombi. Cases 1 and 2 developed right heart thrombi after radiofrequency ablation for atrioventricular nodal reentrant tachycardia and case 3 had tachycardia-related cardiomyopathy and a left ventricular thrombus. In all three patients, the intracardiac thrombi were successfully eliminated following t-PA therapy without major bleeding complications. These observations suggest that t-PA is effective in lysing new thrombus complicating radiofrequency ablation or heart failure and may be the therapy of choice in these conditions.