American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Case Reports. 2020, 8(9), 281-283
DOI: 10.12691/ajmcr-8-9-7
Open AccessCase Report

Non-Compaction Cardiomyopathy Presented with Atrial Fibrillation: A Case Report and Literature Review

Tian Li1, Leonel Mendoza1, Wesley Chan1 and Isabel M. McFarlane1,

1Department of Medicine, State University of New York Downstate Health Science University, Brooklyn, NY 11203 USA

Pub. Date: May 29, 2020

Cite this paper:
Tian Li, Leonel Mendoza, Wesley Chan and Isabel M. McFarlane. Non-Compaction Cardiomyopathy Presented with Atrial Fibrillation: A Case Report and Literature Review. American Journal of Medical Case Reports. 2020; 8(9):281-283. doi: 10.12691/ajmcr-8-9-7


Background: Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy characterized by increased trabeculation in one or more segments of the ventricle. LVNC presented with non-specific symptoms and highly variable clinical presentation ranging from asymptomatic to progressive heart failure and recurrent or life-threatening arrhythmias. Case presentation: 54-year-old Black man with a history of hypertension, diabetes and end-stage renal disease presented with one day palpitations and lightheadedness following a dialysis session. He denied any dyspnea or syncope. On examination, blood pressure was 175/91 mmHg with irregular pulse. No murmur, rubs or gallops were appreciated. Laboratory were unremarkable except increased creatinine and mild anemia with normal thyroid function test. Electrocardiogram (ECG) revealed atrial fibrillation with normal ventricular rate. Transthoracic echocardiogram revealed mildly increased left ventricular (LV) wall thickness with prominent trabeculation and ejection fraction of 55-60 percent, a pseudo-normal LV filling pattern, with concomitant abnormal relaxation and increased filling pressure, suggestive of LVNC. The patient was switched to apixaban. Genetic testing was recommended for family members. Conclusions: LVNC is rare congenital cardiomyopathy with non-specific symptoms and should be considered among the possible diagnosis in patients presenting with arrythmia patients. Echocardiographic and cardiac magnetic resonance imaging can be utilized to establish diagnosis.

Cardiac arrythmia Non-compaction Cardiomyopathy Trabeculation spongiform

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


Figure of 2


[1]  Stanton C, Bruce C, Connolly H, Brady P, Syed I, Hodge D, Asirvatham S, Friedman P: Isolated left ventricular noncompaction syndrome. Am J Cardiol 2009, 104(8): 1135-1138.
[2]  Kubik M, Dabrowska-Kugacka A, Lewicka E, Danilowicz-Szymanowicz L, Raczak G: Predictors of poor outcome in patients with left ventricular noncompaction: Review of the literature. Adv Clin Exp Med 2018, 27(3): 415-422.
[3]  Sarma RJ, Chana A, Elkayam U: Left ventricular noncompaction. Prog Cardiovasc Dis 2010, 52(4): 264-273.
[4]  Jenni R, Oechslin EN, van der Loo B: Isolated ventricular non-compaction of the myocardium in adults. Heart 2007, 93(1): 11-15.
[5]  Arbustini E, Favalli V, Narula N, Serio A, Grasso M: Left Ventricular Noncompaction: A Distinct Genetic Cardiomyopathy? J Am Coll Cardiol 2016, 68(9): 949-966.
[6]  Miyake CY, Kim JJ: Arrhythmias in left ventricular noncompaction. Card Electrophysiol Clin 2015, 7(2): 319-330.
[7]  Jenni R, Oechslin E, Schneider J, Jost CA, Kaufmann PA: Echocardiographic and pathoanatomical characteristics of isolated left ventricular non-compaction: a step towards classification as a distinct cardiomyopathy. Heart 2001, 86(6): 666-671.
[8]  Stollberger C, Gerecke B, Finsterer J, Engberding R: Refinement of echocardiographic criteria for left ventricular noncompaction. Int J Cardiol 2013, 165(3): 463-467.
[9]  Gebhard C, Stahli BE, Greutmann M, Biaggi P, Jenni R, Tanner FC: Reduced left ventricular compacta thickness: a novel echocardiographic criterion for non-compaction cardiomyopathy. J Am Soc Echocardiogr 2012, 25(10): 1050-1057.
[10]  Zuccarino F, Vollmer I, Sanchez G, Navallas M, Pugliese F, Gayete A: Left ventricular noncompaction: imaging findings and diagnostic criteria. AJR Am J Roentgenol 2015, 204(5): W519-530.
[11]  Petersen SE, Selvanayagam JB, Wiesmann F, Robson MD, Francis JM, Anderson RH, Watkins H, Neubauer S: Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging. J Am Coll Cardiol 2005, 46(1): 101-105.
[12]  Jacquier A, Thuny F, Jop B, Giorgi R, Cohen F, Gaubert JY, Vidal V, Bartoli JM, Habib G, Moulin G: Measurement of trabeculated left ventricular mass using cardiac magnetic resonance imaging in the diagnosis of left ventricular non-compaction. Eur Heart J 2010, 31(9): 1098-1104.
[13]  Grothoff M, Pachowsky M, Hoffmann J, Posch M, Klaassen S, Lehmkuhl L, Gutberlet M: Value of cardiovascular MR in diagnosing left ventricular non-compaction cardiomyopathy and in discriminating between other cardiomyopathies. Eur Radiol 2012, 22(12): 2699-2709.
[14]  Towbin JA, McKenna WJ, Abrams DJ, Ackerman MJ, Calkins H, Darrieux FCC, Daubert JP, de Chillou C, DePasquale EC, Desai MY et al: 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy. Heart Rhythm 2019, 16(11): e301-e372.