Abstract
In patients with persistent atrial fibrillation, adverse atrial remodeling may induce annular enlargement causing severe mitral- or tricuspid valve regurgitation and heart failure symptoms. Herein, we describe a case of rapidly progressive right atrial (RA) adverse remodeling due to new onset persistent AF, causing tricuspid annular dilatation and torrential tricuspid regurgitation (TR) in a 79-year-old female patient. This condition could be diagnosed by echocardiography, which helped guiding further patient management. After successful electric cardioversion, reverse RA remodeling took place, resulting in resolution of RA enlargement, TR and clinical symptoms within a few weeks. To maintain sinus rhythm, the patient underwent cryoablation and her further clinical course was uneventful.