Key result
Combined PFA and LAAO safely achieves one-year asymptomatic follow-up in a high-risk AF patient.
Why the study?
Combining pulsed field ablation with left atrial appendage occlusion represents a holistic strategy for rhythm control and stroke risk reduction in patients with high thromboembolic and bleeding risks.
Case Report (n=1)
A single-session combined pulsed field ablation and left atrial appendage occlusion was safe and effective in a patient with persistent AF and high bleeding risk.
Supports combined PFA-LAAO feasibility in high-risk persistent AF; hypothesis-generating and requires prospective trials before broader use.
Background Pulsed field ablation (PFA) is an emerging modality for atrial fibrillation management, offering rapid pulmonary vein isolation and the possibility of the left atrial posterior wall ablation. Combining PFA with left atrial appendage occlusion (LAAO) represents a holistic strategy for managing heart rhythm abnormalities and minimizing stroke risk, particularly in patients with high thromboembolic and bleeding risks. Case summary We present a case of a 52-year-old woman with persistent atrial fibrillation, recent percutaneous coronary intervention, and a history of adenomyosis-related menorrhagia, exacerbated by the use of dual antithrombotic therapy. She underwent a single-session PFA and LAAO. The procedure was uncomplicated. At three-month follow-up, imaging confirmed appropriate device placement and complete closure. Anticoagulation was discontinued at three months, and the patient remained asymptomatic at one year follow up while on single antiplatelet therapy. Discussion This case highlights the feasibility and safety of combining PFA and LAAO in a high-risk patient and underscores the potential for broader adoption in selected populations. Larger studies are needed to evaluate long-term outcomes.
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Alexiou et al. (2026) conducted a case report in Persistent atrial fibrillation and adenomyosis-related menorrhagia (n=1). Combined Pulsed Field Ablation (PFA) and Left Atrial Appendage Occlusion (LAAO) was evaluated on Clinical outcome and device placement. Combined pulsed field ablation and left atrial appendage occlusion was safely performed in a high-risk patient with persistent atrial fibrillation, who remained asymptomatic at one-year follow-up.
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