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Updated: Oct 18, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
[Less Invasive Surgical Closure of the Left Atrial Appendage for Cardiogenic Cerebral Embolism in a Patient with
Yoshiki Yamasaki1, Kanan Kurahashi, Daisuke Arima
1Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, Tsukuba, Japan.
Insights
Surgical closure of the left atrial appendage effectively prevents thromboembolism in patients with atrial fibrillation and dilated cardiomyopathy. This less invasive approach offers a safe and lasting solution for high-risk cardiac patients.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Non-valvular atrial fibrillation (Af) and dilated cardiomyopathy (DCM) increase cardiogenic thromboembolism risk.
- Left atrial appendage (LAA) closure is crucial for preventing stroke in high-risk patients.
Observation:
- A 57-year-old man with Af and DCM had a history of thromboembolism, contraindicating catheter ablation.
- Despite anticoagulation, the patient experienced an ischemic stroke, necessitating aggressive therapy and LAA thrombus resolution.
Findings:
- Less invasive surgical LAA closure was successfully performed.
- The patient remained free of thromboembolic events for one year post-surgery.
Implications:
- Less invasive LAA closure is a viable and effective strategy for preventing thromboembolism in high-risk Af patients.
- This approach offers a safe alternative when other treatments are contraindicated or have failed.
Abstract:
Less invasive surgical closure of the left atrial appendage is recommended to prevent cardiogenic thromboembolism in patients with chronic non-valvular atrial fibrillation( Af) and other high-risk cardiac diseases such as dilated cardiomyopathy (DCM). We report a case of a 57-year-old man with Af and DCM. Catheter ablation for Af was contraindicated in this patient with a history of cardiogenic thromboembolism, and anticoagulation therapy was initiated. Despite anticoagulation therapy, the patient developed another ischemic stroke and we administered aggressive anticoagulation therapy resulting in successful resolution of the left atrial appendage thrombus. Less invasive surgical closure of the left atrial appendage was successfully performed, and thromboembolism has not recurred for one year postoperatively.
