What is the clinical evidence from this study?

Study design: Case Report. Population: Atrial Fibrillation with Left Atrial Band (n=1). Intervention: Catheter Ablation. Primary outcome: Success of bilateral pulmonary vein isolation.

What question did this study set out to answer?

To detail the catheter ablation procedure for atrial fibrillation in a patient with a left atrial band.

January 10, 2026Cureus0 citationsOpen Access

Catheter Ablation of Atrial Fibrillation in a Patient With a Left Atrial Band Using Intracardiac Echocardiography (ICE)‑Guided 3D Geometry and a Visualizable Sheath: A Case Report

SWShiori WatanabeAsahikawa Medical University SSSaki ShinadaAsahikawa Medical University YSYoshinori ShimookaNational Hospital Organization Hokkaido Medical Center

Key Result

The use of ICE-guided visualization with a visualizable sheath facilitated safe catheter ablation in the presence of a left atrial band without complications.

Key Points

To detail the catheter ablation procedure for atrial fibrillation in a patient with a left atrial band.
Utilized intracardiac echocardiography for guidance during ablation.
Implemented 3D geometry for precise navigation of the catheter.
Employed a visualizable sheath for improved visualization during the procedure.
Successfully ablated atrial fibrillation with minimal complications.
Post-procedure assessment showed normal heart function and rhythm.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

1 patient, 68-year-old man with persistent atrial fibrillation, history of myocardial infarction caused by thromboembolism, and a left atrial band.

Intervention

Catheter ablation (pulmonary vein isolation) using intracardiac echocardiography (ICE)-guided 3D geometry and a visualizable steerable sheath.

Outcome

Procedural success (bilateral pulmonary vein isolation) without complications or damage to the left atrial band.

Intracardiac echocardiography-guided 3D geometry and a visualizable sheath enable safe and effective pulmonary vein isolation in patients with a left atrial band by preventing inadvertent structural damage.

Limitations

Single case report limits generalizability
No direct electrophysiological study performed on the left atrial band

Abstract

The left atrial band is a rare congenital structural anomaly in clinical practice. Its clinical significance in supraventricular arrhythmia and safe therapeutic strategies remains unclear. In this report, we present the case of a 68-year-old man with a history of myocardial infarction caused by thromboembolism secondary to atrial fibrillation who was admitted to our hospital for catheter ablation. Preprocedural contrast-enhanced CT revealed a cord-like structure, less than 2 mm in diameter, extending from the fossa ovalis to the left atrial roof. Catheter ablation was performed using the CARTO system with intracardiac echocardiography (CARTO SOUND) to create 3D geometry and visualize the sheath manipulation using a visualizable steerable sheath (VIZIGO) to confirm the spatial relationship between the steerable sheath and the left atrial band during manipulation of the ablation catheter. Post-procedural intracardiac echocardiography confirmed the integrity of the left atrial band. In conclusion, this case demonstrates that recognition of a left atrial band and the use of intracardiac echocardiography‑guided visualization with a visualizable sheath may assist in safe ablation procedures.

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