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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Pulsed-Field Ablation for Atrial Premature Complexes From the Right Atrial Appendage Apex: A Novel Application
Lu Geng1, Zhanxin Zhang1, Yaqiong Jin1
1Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
Background:
Atrial premature complexes (APCs) refractory to medical therapy pose management challenges. Pulsed-field ablation (PFA) is established for atrial fibrillation but is unreported for focal APCs.
Case Summary:
A 67-year-old woman with hypertension and hypothyroidism presented with 6-year refractory APCs (35.7% burden). Initial radiofrequency ablation at the right atrial appendage (RAA) apex failed owing to safety concerns. Subsequent PFA eliminated the APCs after 8 applications.
Discussion:
This first report demonstrates the efficacy of PFA for APCs originating from the RAA apex, avoiding the risks of thermal ablation in thin-walled structures.
Take-Home Messages:
PFA safely eliminates arrhythmias originating from the thin-walled RAA apex. This novel approach avoids thermal ablation risks in high-risk anatomical sites.
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Pre-Procedural Preparation