Immediate Cardioversion During Left Atrial Appendage Occlusion in Three Patients With Left Atrial Appendage Thrombus
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Updated: Sep 4, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Nihan Bahadır1, Fatih Akkaya1, Osman Bektaş1
1Faculty of Medicine, Department of Cardiology, Ordu University, Ordu, Turkey.
Purpose:
We report the first cases of direct current cardioversion (DCCV) performed during percutaneous left atrial appendage occlusion (LAAO) in patients with left atrial appendage thrombus and assess its technical feasibility.
Methods:
Three patients with left atrial appendage thrombus and absolute indications for LAAO underwent DCCV during the procedure because of hemodynamic instability from rapid atrial fibrillation.
Results:
A single 200-J shock restored sinus rhythm in all patients. No device migration, embolization, significant peridevice leak, or neurologic events occurred. Follow-up imaging confirmed stable device position.
Conclusions:
DCCV during LAAO appears technically feasible in selected patients, although larger studies are needed to confirm safety.
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