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Updated: Jul 2, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Combined Catheter Ablation and Left Atrial Appendage Occlusion in Atrial Fibrillation: From Data to Clinical Reality
Kyriakos Dimitriadis1, Eleni Adamopoulou2, Nikolaos Pyrpyris2
1First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vas Sofias 114, 115 27, Athens, Greece. dimitriadiskyr@yahoo.gr.
Insights
Combined catheter ablation and left atrial appendage occlusion (LAAO) is a safe and effective single procedure for atrial fibrillation (AF). This one-stop approach reduces stroke and arrhythmia incidence, offering a cost-effective treatment option.
Area of Science:
- Cardiology
- Interventional Cardiology
- Electrophysiology
Background:
- Atrial fibrillation (AF) management requires addressing both symptom control and thromboembolic event prevention.
- Catheter ablation and left atrial appendage occlusion (LAAO) are established treatments for these respective goals.
- Concomitant performance of ablation and LAAO in a single procedure is gaining interest.
Purpose of the Study:
- To review current data on combined catheter ablation and LAAO procedures.
- To summarize the rationale, techniques, clinical efficacy, and indications for this combined approach.
- To explore future directions for one-stop AF treatment.
Main Methods:
- Extensive literature search conducted using the MEDLINE/PubMed database.
- Identification and synthesis of relevant studies on combined ablation and LAAO procedures.
Main Results:
- High success rates (frequently 100%) reported for the combined procedure by experienced operators.
- Low periprocedural and follow-up complication rates, with significant reductions in stroke, bleeding, and arrhythmia incidence.
- Potential positive effects on left atrial mechanical function and reverse remodeling observed, though some studies note a possible increase in peri-device leaks (PDLs).
- Most studies are small and observational, lacking randomized controlled trials.
Conclusions:
- Combined catheter ablation and LAAO can be safely and effectively performed as a cost-effective single procedure.
- Careful patient selection is crucial for successful outcomes.
- Further research, including randomized controlled trials, is needed to fully elucidate the benefits and risks.
Purpose:
Atrial fibrillation (AF) requires treatment that focuses on two main goals: symptom control and prevention of thromboembolic events. Catheter ablation and left atrial appendage occlusion (LAAO) constitute two well-established treatment methods in selected patients that accomplish these two goals correspondingly. Recently, there is increasing interest in performing the two procedures concomitantly in a so-called "combined" or "one-stop" procedure. This review aims to summarize the current data on the combined procedure, from the rationale and the techniques to its clinical efficacy, indications and future directions.
Methods:
An extensive search has been conducted using the MEDLINE/PubMed database to identify the relevant studies.
Results:
The reported success rates of the combined procedure are very high and frequently reach 100% when performed by experienced operators. The periprocedural and follow-up complications are low, the procedure is cost-effective, while there is significant stroke, bleeding and arrhythmia incidence reduction that does not seem to be undermined by interference between the two interventions. There are also a few indications that the one-stop procedure has a positive effect on left atrial mechanical function as it has been correlated with left atrial reverse remodeling. On the other hand, some studies suggest possible increase in peri-device leaks (PDLs), compared with LAAO alone, which could in turn negatively affect the clinical outcomes. Most available studies are small and observational, with a lack of randomized controlled trials.
Conclusion:
Catheter ablation and left atrial appendage occlusion can be safely and effectively combined in a cost-effective single procedure in carefully selected patients.
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