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Interatrial Stent to Treat Stiff Left Atrium Syndrome
Danish Zaidi1, Derek Williams2, David Zhao3
1Department of Internal Medicine, Yale-New Haven Hospital, New Haven, CT, United States of America.
Summary
Stiff left atrial syndrome (SLAS), a complication of catheter ablation for atrial fibrillation, can be treated with atrial septostomy. An interatrial stent was used to maintain the therapeutic benefit of septostomy in a patient with symptomatic SLAS.
Area of Science:
- Cardiology
- Interventional Cardiology
- Electrophysiology
Background:
- Catheter ablation for atrial fibrillation (CAAF) can lead to stiff left atrial syndrome (SLAS) in up to 8% of patients.
- SLAS diagnosis is challenging, often confused with heart failure with preserved ejection fraction (HFpEF) due to overlapping symptoms.
- Current treatment options for SLAS can be limited.
Observation:
- This case report details the first use of an interatrial stent to sustain the benefits of atrial septostomy in a patient with symptomatic SLAS.
- The patient presented with symptoms consistent with SLAS following CAAF.
- Interatrial shunt devices have shown promise for HFpEF but their use in SLAS was previously undescribed.
Findings:
- Atrial septostomy provided significant symptomatic relief for the patient with SLAS.
- The interatrial stent successfully maintained the patency and therapeutic effect of the atrial septostomy.
- This intervention offers a novel approach to managing complex SLAS cases.
Implications:
- SLAS should be considered in patients with dyspnea after CAAF, especially when other causes are ruled out.
- Interatrial stenting may be a valuable technique to enhance the efficacy and durability of atrial septostomy for SLAS.
- This approach could offer a new therapeutic avenue for patients with refractory SLAS.
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