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Updated: Sep 11, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Targeted Aspiration of Localized Left Atrial Appendage Air Entrapment During Atrial Fibrillation Ablation
Bowen Zhou1, Yijun Wang2, Jingtao Hu1
1Department of Cardiology, Suzhou First People's Hospital, Suzhou, Anhui, China.
Background:
Air embolism is a rare but potentially catastrophic complication of atrial fibrillation ablation, and evidence guiding management of localized left atrial appendage (LAA) air entrapment is limited.
Case Summary:
A 69-year-old woman undergoing ablation for persistent atrial fibrillation developed localized LAA air entrapment when incorrect positioning of a 3-way stopcock during deairing allowed air to enter the ablation-catheter irrigation circuit. Fluoroscopy prompted immediate cessation of ablation. Stepwise aspiration using the indwelling ablation catheter, a larger-bore sheath near the LAA ostium, and targeted catheter aspiration of residual distal air resulted in disappearance of the visible air shadow. Ablation was completed without further acute complications.
Discussion:
This case illustrates an anatomy-oriented aspiration strategy for air confined within an angulated LAA recess.
Take-Home Messages:
Stopcock position and irrigation flow should be verified during deairing. Prompt recognition and cautious stepwise aspiration may facilitate management in selected cases.
