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Updated: Dec 23, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Isolated surgical left atrial appendage closure: Revisiting utility and indications in a burgeoning era of
Paula M Hernandez1, Sanjay Divakaran2, Dale S Adler2
1Department of Internal Medicine, University of South Florida, Tampa, Florida.
Insights
Surgical left atrial appendage excision is a viable option for stroke prevention in atrial fibrillation patients with recurrent thromboembolic events and contraindications to standard therapies.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Atrial fibrillation (AF) management for stroke prevention typically involves oral anticoagulation (AC) or left atrial appendage (LAA) occlusion.
- A subset of AF patients face high risks with these standard treatments, necessitating alternative strategies.
Observation:
- A 63-year-old female with AF experienced recurrent thromboembolic events and an acute intraparenchymal hemorrhage.
- An intracardiac thrombus was identified, and she had contraindications for both AC and LAA occlusion.
Findings:
- Isolated surgical LAA excision was successfully performed in this high-risk patient.
- The patient has remained event-free following the surgical intervention.
Implications:
- Surgical LAA excision remains a valuable therapeutic option for selected AF patients with intracardiac thrombi.
- This approach offers a successful alternative when standard stroke prevention methods are contraindicated.
Background And Aim:
Oral anticoagulation (AC) and percutaneous left atrial appendage (LAA) occlusion are the primary treatment modalities for stroke prevention in atrial fibrillation (AF), but there remains a subset of patients in whom these approaches present excess risk and isolated surgical LAA excision should be considered. We describe a 63-year-old female with AF and recurrent thromboembolic events who presented with an acute intraparenchymal hemorrhage and was found to have an intracardiac thrombus.
Methods:
Given contraindications to AC and LAA occlusion, an isolated LAA surgical excision was pursued.
Results:
She underwent successful surgical LAA excision and has since remained event-free.
Conclusion:
It is important to recall the utility of therapies that have been previously used with success for intracardiac thrombi and still remain as viable options.
