Key result
Concurrent convergent ablation and Atriclip exclusion of the left atrial appendage successfully restored sinus rhythm and occluded the appendage in a 54-year-old man with refractory persistent AF.
Case Report (n=1)
Concurrent convergent ablation and AtriClip exclusion of the LAA may be a feasible and effective approach for patients with longstanding persistent atrial fibrillation refractory to cardioversion.
Single-case hybrid ablation plus LAA exclusion in refractory AF with enlarged LA leaves open efficacy, safety, and generalizability.
We here present a case of a 54-year-old man with longstanding persistent atrial fibrillation refractory to direct current electrical cardioversion who underwent a concurrent convergent ablation and Atriclip exclusion of left atrial appendage. His preoperative echocardiography revealed dilated 5.8 cm left atrium with a normal left ventricular ejection fraction of 50%. Transmural isolation of pulmonary veins was performed through a subxiphoid approach, and 3 left-sided video-assisted thoracoscopic surgery ports were utilised to occlude the base of the left atrium appendage with the Atriclip device. A peri-operative transoesophageal echocardiogram confirmed left atrium appendage base occlusion, and the patient was in sinus rhythm after having a single 200 kJ direct current cardioversion shock. The postoperative period was uneventful, and the patient was discharged with preprocedural anticoagulant after 24 hours of the procedure and advised to come for follow up after 3 months.
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Ranjan et al. (2022) conducted a case report in longstanding persistent atrial fibrillation (n=1). concurrent convergent ablation and Atriclip exclusion of left atrial appendage was evaluated on sinus rhythm and left atrium appendage base occlusion. Concurrent convergent ablation and Atriclip exclusion of the left atrial appendage successfully restored sinus rhythm and occluded the appendage in a 54-year-old man with refractory persistent AF.
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