Left Atrial Appendage Aneurysm and Atrial Fibrillation

BACKGROUND: Left atrial appendage aneurysm is a rare clinical entity that may cause arrhythmias and thromboembolism. CASE SUMMARY: We present the case of a 36-year-old man with atrial fibrillation and left atrial appendage aneurysm the size of 60 × 40 mm, who underwent surgery with aneurysmectomy and concomitant cryoablation (Cox-Maze IV). The patient had transient episodes of atrial flutter postoperatively, but otherwise an uneventful postoperative course and made a good recovery. DISCUSSION: This case demonstrates the benefits of concomitant aneurysmectomy and surgical ablation in patients with left atrial appendage aneurysm and atrial fibrillation. It reinforces the need for individualized management and supports the use of adjunct surgical ablation in appropriately selected patients. TAKE-HOME MESSAGES: Left atrial appendage aneurysm is strongly associated with atrial arrhythmias and thromboembolism. Although surgery with resection and ablation is beneficial, long-term rhythm surveillance and research are required to better define arrhythmia mechanisms in these patients.