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Left atrial appendage edema and spontaneous echo contrast following pulsed field ablation for pulmonary vein
Jefri1, Beny Hartono2, Evan J Gunawan2
1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia.
Abstract:
Pulsed Field Ablation (PFA) is a novel non-thermal ablation technique with several advantages and fewer complications. A 70-year-old male with persistent atrial fibrillation, heart failure with preserved ejection fraction, and prior ischemic stroke who underwent pulmonary vein isolation using PFA with planned left atrial appendage closure (LAAC). Post-ablation transesophageal echocardiography revealed significant dense spontaneous echo contrast in the left atrial appendage (LAA) and left atrial ridge edema, leading to LAAC postponement and anticoagulation initiation. While PFA has advantages over conventional ablation, its impact on LAA structures requires further study, especially when considering concomitant with LAAC.
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