Related Experiment Video
Updated: Jun 25, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Pulsed field ablation in patients with a prior left atrial appendage closure device and concomitant leak closure
Vincenzo Mirco La Fazia1, Marco Marino2, Emanuele Chiarazzo2
1Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, Texas; Department of Experimental Medicine, Tor Vergata University, Rome, Italy.
Heart Rhythm
|June 23, 2026
Summary
Pulsed field ablation (PFA) is feasible in patients with left atrial appendage occlusion (LAAO) devices. Combining PFA with leak closure shows high procedural success for atrial fibrillation treatment.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Pulsed field ablation (PFA) offers a nonthermal alternative for atrial fibrillation (AF) catheter ablation.
- Limited data exists on PFA efficacy in patients with prior left atrial appendage occlusion (LAAO) devices.
Purpose of the Study:
- Assess the feasibility and safety of PFA in patients with implanted LAAO devices.
- Evaluate outcomes of combined PFA and LAAO leak closure procedures.
Main Methods:
- Analysis of consecutive patients undergoing PFA with or without concomitant leak closure.
- Primary endpoints: procedural success (PFA delivery) and safety (no device dislodgment, new peri-device leaks (PDLs), or device-related thrombus (DRT)).
Main Results:
- 73 patients included; PFA used Farapulse (61.6%) and Affera (38.4%) systems.
- Combined procedure in 24.6%; overall procedural success in 95.9%.
- No new PDLs, DRT, or dislodgment at 2 months with PFA alone; 11.1% residual leaks in the combined group.
Conclusions:
- PFA is feasible in patients with prior LAAO device implantation.
- Combined PFA and leak closure demonstrates high procedural efficacy for AF management.
