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Updated: May 16, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Left Atrial Appendage Membrane in a Patient Presenting With Atrial Fibrillation
Ryan Lee1, Aamir Twing2, Satish Mishra2
1University of Illinois-Chicago College of Medicine, Chicago, Illinois, USA.
Background:
Left atrial appendage (LAA) membranes are rare congenital anomalies of uncertain clinical significance, often discovered incidentally during imaging or interventional procedures.
Case Summary:
A 50-year-old man with paroxysmal atrial fibrillation presented for LAA occlusion device implantation and atrial fibrillation ablation. Transesophageal and intracardiac echocardiography revealed a membrane completely occluding the LAA ostium, as confirmed by Doppler imaging, fluoroscopy, and electroanatomical mapping. No LAA occlusion device was implanted, but AF ablation was successfully performed. The patient was in sinus rhythm and was asymptomatic at follow-up.
Discussion:
A total of 13 cases of LAA membranes have been reported in the literature. Their relationship with atrial arrhythmias and thromboembolism remains unclear. This case demonstrates the use of electroanatomical mapping to confirm the atrial myocardial characteristics of the membrane.
Take-Home Messages:
Anatomic variants such as LAA membranes underscore the importance of advanced imaging and mapping to ensure procedural safety and success in complex cardiac interventions.
