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Updated: Aug 30, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
The Convergent Ablation and AtriClip Exclusion of the Left Atrial Appendage in Long-Standing Persistent Atrial
Redoy Ranjan1,2, Riyaz Kaba2, Venkatachalam Chandrasekaran2
1Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Insights
This case study shows a successful concurrent convergent ablation and Atriclip exclusion for persistent atrial fibrillation. The procedure restored sinus rhythm in a patient refractory to electrical cardioversion.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Persistent atrial fibrillation (AF) poses treatment challenges, often proving refractory to standard therapies like electrical cardioversion.
- Left atrial appendage (LAA) exclusion is a strategy to mitigate stroke risk in AF patients.
- Concurrent ablation and LAA occlusion offer a combined approach to AF management.
Abstract:
We here present a case of a 54-year-old man with longstanding persistent atrial fibrillation refractory to direct current electrical cardioversion who underwent a concurrent convergent ablation and Atriclip exclusion of left atrial appendage. His preoperative echocardiography revealed dilated 5.8 cm left atrium with a normal left ventricular ejection fraction of 50%. Transmural isolation of pulmonary veins was performed through a subxiphoid approach, and 3 left-sided video-assisted thoracoscopic surgery ports were utilised to occlude the base of the left atrium appendage with the Atriclip device. A peri-operative transoesophageal echocardiogram confirmed left atrium appendage base occlusion, and the patient was in sinus rhythm after having a single 200 kJ direct current cardioversion shock. The postoperative period was uneventful, and the patient was discharged with preprocedural anticoagulant after 24 hours of the procedure and advised to come for follow up after 3 months.
