Left atrial appendage occlusion and pulmonary vein isolation: interest of non-invasive imaging

A 67-year-old woman with paroxysmal atrial fibrillation (AF), not a candidate for anticoagulant therapy, underwent a combined procedure of pulmonary vein isolation (PVI) and occlusion of the left atrial appendage (LAA) with the Amplatzer cardiac plug prosthesis (AGA Medical Corporation, Plymouth, U.S.A.). After PVI, implantation of the Amplatzer cardiac plug was performed under transoesophageal echocardiography guidance after a complete evaluation of the LAA obtained by different imaging techniques. One month later, multidetector computed tomography and transoesophageal echocardiography confirmed proper position of the Amplatzer cardiac plug not interfering with the surrounding structures and the absence of complications resulting from either PVI or LAA closure.