An ICE-guided one-stop procedure combining AF ablation and LAAC successfully maintained sinus rhythm and prevented stroke over 12 months in a patient with persistent AF and cor triatriatum sinister.
Case Report (n=1)
No
An ICE-guided one-stop procedure combining AF ablation and LAAC is a safe and effective treatment option for patients with persistent AF and complex congenital anomalies like cor triatriatum sinister.
This case report describes the treatment of a 76-year-old male patient diagnosed with persistent atrial fibrillation (AF) and cor triatriatum sinister (CTS). The patient presented with palpitations and shortness of breath for four years, exacerbated over two weeks. Cardiac ultrasound and computed tomography angiography (CTA) confirmed Bank II type complete CTS, with all four pulmonary veins draining into an accessory atrium. The patient also had lacunar stroke and heart failure, with a CHA2DS2-VASc score of 5 and HAS-BLED score of 2, indicating high stroke risk and moderate bleeding risk. Given the anatomical abnormalities and clinical characteristics, we performed a one-stop procedure under intracardiac echocardiography (ICE) guidance, combining AF radiofrequency ablation and left atrial appendage closure (LAAC). Post-procedure recovery was uneventful, and follow-up transesophageal echocardiography showed no residual shunt or thrombus around the occluder. An antithrombotic regimen of rivaroxaban 15 mg once daily for three months followed by aspirin 100 mg once daily long-term was prescribed. This case highlights the critical role of ICE technology in complex cardiac anatomy and the importance of personalized antithrombotic strategies in high-risk AF patients.
Zhang et al. (Fri,) conducted a case report in Persistent atrial fibrillation and cor triatriatum sinister (n=1). ICE-guided one-stop procedure (AF radiofrequency ablation and left atrial appendage closure) was evaluated on Maintenance of sinus rhythm and absence of residual shunt or thrombus. An ICE-guided one-stop procedure combining AF ablation and LAAC successfully maintained sinus rhythm and prevented stroke over 12 months in a patient with persistent AF and cor triatriatum sinister.