[Electrical isolation of the left atrial appendage : Benefits and risks]

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Anatomy

Background:

• The left atrial appendage (LAA) is an anatomical structure arising from the left atrium.
• It is a primary source of intracardiac thrombi and a trigger for atrial tachyarrhythmia and atrial fibrillation (AF).
• Different LAA morphologies exist, influencing its function and clinical relevance.

Purpose of the Study:

• To evaluate the role of LAA isolation in managing atrial fibrillation.
• To investigate the potential increased risk of LAA thrombi and thromboembolisms post-isolation.
• To discuss the implications of LAA isolation strategies on clinical outcomes.

Main Methods:

• Review of current literature on LAA morphology, function, and electrophysiological significance.
• Analysis of studies investigating LAA isolation techniques (e.g., radiofrequency ablation).
• Assessment of data regarding the incidence of thrombi and thromboembolisms after LAA isolation.

Main Results:

• LAA isolation, alongside pulmonary vein isolation, is increasingly used for persistent AF.
• This strategy may increase the incidence of LAA thrombi and systemic thromboembolisms.
• The risk appears dependent on the specific ablation strategy employed.

Conclusions:

• Electrical isolation of the LAA is a growing strategy for AF management.
• Post-isolation LAA thrombi and thromboembolism incidence warrants careful consideration.
• Mechanical occlusion of the LAA should be discussed with patients undergoing electrical isolation.