Why the study?
Does combined cryoballoon ablation of the pulmonary veins, posterior wall, left atrial appendage, and mitral isthmus followed by LAA closure improve outcomes in patients with long-standing persistent atrial fibrillation and intolerance to oral anticoagulation?
Does combined cryoballoon ablation of the pulmonary veins, posterior wall, left atrial appendage, and mitral isthmus followed by LAA closure improve outcomes in patients with long-standing persistent atrial fibrillation and intolerance to oral anticoagulation?
This first reported case illustrates the safety and feasibility of combined cryoballoon ablation of the pulmonary veins, posterior wall, left atrial appendage, and mitral isthmus followed by LAA closure in a patient with long-standing persistent atrial fibrillation.
Feasibility of integrated cryoballoon ablation and ICE-guided LAA closure shown in one case; leaves open safety, efficacy, and outcomes in persistent AF.
Here, we describe the first reported case of pulmonary vein, posterior wall, and left atrial appendage (LAA) isolation with concomitant ablation of a mitral isthmus flutter using the cryoballoon, guided by intracardiac echocardiography (ICE)-integrated 3-dimensional mapping in a patient with long-standing persistent atrial fibrillation and intolerance to long-term oral anticoagulation, followed by ICE-guided LAA closure using an endocardial occlusion device. This report illustrates the safety and feasibility of this combined approach. Additionally, it advocates for empiric LAA isolation prior to LAA occlusion, as LAA ablation/isolation can prove challenging in those with existing endocardial LAA occlusion devices should they require subsequent ablations to target arrhythmias or triggers arising from this structure.
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Aryana et al. (2022) studied this question.
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