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Updated: Apr 29, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left atrial thrombus after complete left atrial appendage exclusion with LARIAT device
Ketan P Koranne1, Rajeev R Fernando, Susan T Laing
1Division of Cadiovascular Medicine, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
Insights
Left atrial appendage ligation using the LARIAT device can lead to thrombus formation post-procedure. Anticoagulation therapy is crucial for resolving these left atrial thrombi.
Area of Science:
- Cardiology
- Medical Devices
- Thrombosis Research
Background:
- Atrial fibrillation necessitates treatments like left atrial appendage (LAA) exclusion.
- The LARIAT snare device is used for LAA exclusion to prevent stroke.
- Understanding post-procedural complications is vital for patient safety.
Observation:
- A patient treated with LARIAT device for LAA exclusion developed a left atrial thrombus.
- The thrombus was located at the orifice of the excluded LAA.
- Echocardiography confirmed the presence of the thrombus one month post-procedure.
Findings:
- Complete occlusion of the LAA by the LARIAT device did not prevent thrombus formation.
- The left atrial thrombus resolved after two months of anticoagulation therapy.
- This case indicates a continued risk of left atrial thrombosis after LAA ligation.
Implications:
- LAA exclusion with LARIAT devices may still pose a risk for thromboembolic events.
- Further research is needed to establish optimal antiplatelet and anticoagulation strategies post-LARIAT.
- Clinical vigilance and appropriate medical management are essential for patients undergoing LAA exclusion.
Abstract:
A 74-year-old woman with paroxysmal atrial fibrillation underwent left atrial appendage (LAA) exclusion with a LARIAT snare device. Transesophageal echocardiogram one month later demonstrated a left atrial thrombus at orifice of the completely occluded LAA that subsequently resolved with two months of anticoagulation. This case highlights that LAA ligation with LARIAT device continues to pose a risk for left atrial thrombosis in the immediate post-operative period. It also emphasizes the need for further evidence regarding antiplatelet and anticoagulation therapy in these patients. © 2014 Wiley Periodicals, Inc.
