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Updated: Jun 20, 2026
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
33.9K
A new left atrial appendage isolation strategy for persistent atrial fibrillation requiring repeat ablation
Patricia Tung1, Juliana Pérez-Pinzón2, Daniel Villarreal Garcia1
1Harvard Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Heart Rhythm
|December 21, 2025
Summary
Left atrial appendage isolation (LAAI) using anterior and posterior mitral lines with Vein of Marshall ethanol ablation is feasible for persistent atrial fibrillation (AF) patients. This approach shows durable LAAI and reduced arrhythmia recurrence, with no reported strokes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- The left atrial appendage (LAA) is a key source of atrial fibrillation (AF) triggers in patients undergoing repeat ablation.
- Previous left atrial appendage isolation (LAAI) methods had variable success and risks.
Purpose of the Study:
- To evaluate the feasibility and efficacy of LAAI using anterior mitral line (AML) and posterior mitral line (PML) plus Vein of Marshall ethanol ablation (VOM).
- To assess the durability of LAAI and its impact on arrhythmia recurrence in persistent AF patients.
Main Methods:
- Prospective study of 23 patients undergoing repeat ablation for persistent AF.
- LAAI performed using AML and PML, with or without VOM.
- Systematic remapping for LAAI durability assessment and Kaplan-Meier analysis for arrhythmia-free survival.
Main Results:
- Acute LAAI achieved in all patients; durable LAAI in 61%.
- Arrhythmia recurrence rate was 61% at 1 year, predominantly atrial tachycardia (AT).
- No acute thrombus, strokes, or TIAs observed.
Conclusions:
- LAAI via linear AML and PML approach with VOM is feasible and reproducible.
- This technique leads to a low rate of self-limited arrhythmia recurrences.
- The method demonstrates safety and potential for improved outcomes in persistent AF.
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