Left atrial appendage edema and spontaneous echo contrast following pulsed field ablation for pulmonary vein isolation: A case report

Figures

• 

  Fig. 1. Pre-ablation TEE in multiple views demonstrating the left atrial appendage anatomy and surrounding structures. In the 133-degree view, the LAA morphology is classified as cauliflower. No spontaneous echo contrast (SEC) or thrombus is observed. AO = aorta; LA = left atrium; LAA = left atrial appendage; LCx = left circumflex artery; LSPV = left superior pulmonary vein; PA = pulmonary artery.

• 

  Fig. 2. PFA procedure using the Farawave ablation catheter with four applications in the basket and flower configuration for each pulmonary vein. The first ablation was performed in the RSPV (a and b), followed by the RIPV (c and d), then the LSPV (e and f), and finally in the LIPV (g and h). CS = coronary sinus; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; PFA = pulsed field ablation; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein.

• 

  Fig. 3. Comparison of pre-ablation (left) and post-ablation (right) TEE images showing edema in the LA ridge and LAA, resulting in a smaller LAA ostium compared to baseline. A dense SEC filling the LAA is observed. LA = left atrium; LAA = left atrial appendage; SEC = spontaneous echo contrast.