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Updated: Dec 5, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
The proof is in the appendage: A case report of a fenestrated membrane overlying the left atrial appendage
Jaime Holbert1, Ben Shepple1, Bret Rogers1
1Department of Medicine, University of Tennessee Medical Center, Knoxville, TN, USA.
Abstract:
A 35-year-old man with history of recurrent arrhythmias presented for pulmonary vein isolation. He underwent pre-procedural screening for thromboembolism risk with transesophageal echocardiogram. He had an incidental finding of a rare fenestrated membrane overlying his left atrial appendage. Additional workup throughout his clinical course revealed genetic mutations in the LMNA and SNTA1 genes. There have been no previous reported genetic mutations reported in cases with LAA membranes.
Insights
A rare membrane in the left atrial appendage was incidentally discovered in a patient with arrhythmias. Genetic analysis revealed novel mutations in LMNA and SNTA1 genes, previously unreported in association with left atrial appendage membranes.
Area of Science:
- Cardiology
- Genetics
- Medical Imaging
Background:
- Recurrent arrhythmias necessitate procedures like pulmonary vein isolation.
- Pre-procedural screening for thromboembolism risk is standard practice.
- Transesophageal echocardiography is a key diagnostic tool.
Observation:
- A rare fenestrated membrane was incidentally found overlying the left atrial appendage during screening.
- The patient presented with a history of recurrent arrhythmias.
- The membrane was identified via transesophageal echocardiogram.
Findings:
- Genetic analysis identified mutations in the LMNA and SNTA1 genes.
- These genetic mutations have not been previously reported in patients with left atrial appendage membranes.
- The coexistence of a left atrial appendage membrane and these specific genetic mutations is novel.
Implications:
- This case highlights a potential, previously unrecognized genetic association with left atrial appendage membranes.
- Further research may elucidate the role of LMNA and SNTA1 mutations in the formation or presence of these membranes.
- Understanding this association could refine risk stratification and management strategies for patients with arrhythmias and atrial anomalies.
