Related Experiment Video
Updated: Nov 6, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Applications designed to successfully implant in challenging left atrial appendage occlusion cases: a new tool for
José Ramón López-Mínguez1, Ginés Martínez-Cáceres2, Reyes González-Fernández2
1Interventional Cardiology Section, Cardiology Service, University Hospital of Badajoz, Avda Elvas sn Badajoz, 06080, Badajoz, Spain. lopez-minguez@hotmail.com.
Insights
This case study highlights left atrial appendage occlusion (LAAO) for an elderly patient with atrial fibrillation experiencing recurrent gastrointestinal bleeding despite anticoagulation. LAAO offers a potential solution for stroke risk reduction in high-risk patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Permanent atrial fibrillation necessitates anticoagulation to prevent stroke.
- Recurrent gastrointestinal bleeding poses a significant risk, complicating anticoagulation management.
- High stroke risk scores (CHA2DS2-VASc=4) and bleeding risk scores (HAS-BLED=3) indicate a complex clinical scenario.
Observation:
- An 85-year-old patient with permanent atrial fibrillation and a DDD pacemaker presented with recurrent gastrointestinal bleedings.
- Anticoagulation with apixaban was insufficient to prevent bleeding events.
- The patient was deemed a candidate for left atrial appendage occlusion (LAAO).
Findings:
- Left atrial appendage occlusion (LAAO) was performed as a therapeutic intervention.
- This procedure aims to mitigate stroke risk in patients with atrial fibrillation.
- LAAO provides an alternative to long-term anticoagulation in specific high-risk patient profiles.
Implications:
- LAAO may be a viable option for patients with atrial fibrillation and high bleeding risk, refractory to anticoagulation.
- This approach could reduce the incidence of both thromboembolic events and major bleeding.
- Further research into LAAO outcomes in complex elderly populations is warranted.
Abstract:
An 85-year-old patient with permanent atrial fibrillation with a DDD pacemaker, and with indication for left atrial appendage occlusion (LAAO). Sent for LAAO due to recurrent gastrointestinal bleedings even on apixaban and with a CHA 2 DS 2 VASc and HAS-BLED scores of 4 and 3 respectively.
