Key result
Direct current cardioversion (200-J shock) during left atrial appendage occlusion successfully restored sinus rhythm in all 3 patients without device migration, embolization, or neurologic events.
Why the study?
To assess the technical feasibility of performing direct current cardioversion during percutaneous left atrial appendage occlusion in patients with left atrial appendage thrombus.
Does direct current cardioversion during left atrial appendage occlusion safely restore sinus rhythm in patients with left atrial appendage thrombus?
Case Report (n=3)
Does direct current cardioversion during left atrial appendage occlusion safely restore sinus rhythm in patients with left atrial appendage thrombus?
Direct current cardioversion during left atrial appendage occlusion appears technically feasible and safe in a small series of patients with LAA thrombus and hemodynamic instability.
PURPOSE: We report the first cases of direct current cardioversion (DCCV) performed during percutaneous left atrial appendage occlusion (LAAO) in patients with left atrial appendage thrombus and assess its technical feasibility. METHODS: Three patients with left atrial appendage thrombus and absolute indications for LAAO underwent DCCV during the procedure because of hemodynamic instability from rapid atrial fibrillation. RESULTS: A single 200-J shock restored sinus rhythm in all patients. No device migration, embolization, significant peridevice leak, or neurologic events occurred. Follow-up imaging confirmed stable device position. CONCLUSIONS: DCCV during LAAO appears technically feasible in selected patients, although larger studies are needed to confirm safety.
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Bahadır et al. (2026) conducted a case report in Left atrial appendage thrombus and rapid atrial fibrillation with hemodynamic instability (n=3). Direct current cardioversion (DCCV) during percutaneous left atrial appendage occlusion (LAAO) was evaluated on Restoration of sinus rhythm and technical feasibility/safety. Direct current cardioversion (200-J shock) during left atrial appendage occlusion successfully restored sinus rhythm in all 3 patients without device migration, embolization, or neurologic events.
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