ArticleReviews in cardiovascular medicine2026
The "Floating Lotus" Sign on Intracardiac Echocardiography: Characterization and Predictors of a Novel Left Atrial Appendage Pseudo-Thrombus.
Article in Reviews in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background: Intracardiac echocardiography (ICE) is increasingly used for left atrial appendage (LAA) assessment during atrial fibrillation (AF) procedures. We describe a novel, thrombus-mimicking artifact on ICE, termed the "Floating Lotus" sign. Methods: In this retrospective multicenter study, we analyzed data from 172 patients undergoing ICE-guided AF ablation and/or LAA occlusion. The incidence, imaging features, and clinical correlates of the "Floating Lotus" sign were assessed. Results: The "Floating Lotus" sign was observed in 48 patients (27.9%). It manifested as a mobile, echogenic mass within an anechoic space, revealing an underlying pericardial effusion. Patients exhibiting the sign had a higher prevalence of recent stroke (35.4% vs. 15.3%, Conclusion: The "Floating Lotus" sign is a common ICE pseudo-thrombus, often associated with heart failure. Accurate recognition of this sign, based on its dynamic imaging features, is therefore critical to prevent misdiagnosis and avoid unnecessary procedural cancellation or anticoagulation changes.
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