A rare case of congenital absence of left atrial appendage diagnosed by multimodal imaging

Congenital absence of the left atrial appendage (LAA) is an exceptionally rare cardiac anomaly. We reported a patient in his 60s with symptomatic persistent atrial fibrillation (AF) and no history of cardiac surgery or other diseases. During preprocedural evaluation for AF cardioversion, transesophageal echocardiography and cardiac computed tomography revealed a complete absence of the LAA. The patient was managed with regular anticoagulation therapy and maintained in sinus rhythm, without recurrence or related complications during a 1-year follow-up.