Work

One-stop strategy combining pulmonary vein isolation with balloon-in-basket pulsed field ablation and left atrial appendage closure: a case report

Year: 2025

Type: article

Abstract: Background: Concomitant pulmonary vein isolation (PVI) and left atrial appendage closure (LAAC) are increasingly performed, with substantial experience from thermal ablation and limited early reports using pulsed field ablation (PFA). This is the first reported case of a combined procedure using a balloon-in-basket PFA system. Case summary: A 75-year-old man with symptomatic paroxysmal atrial fibrillation (AF) and recurrent macrohematuria under oral anticoagulation was referred for treatment. After a multidisciplinary team discussion, we opted for a one-stop approach combining PVI using a balloon-in-basket PFA system and LAAC. The procedure proceeded without complications, and at the end of the procedure and in follow-up imaging, no residual leak was detected. Discussion: This case highlights the feasibility of combining balloon-in-basket based PFA with LAAC in a single procedure. Performing ablation prior to LAAC may help avoid potential interactions between the ablation catheter and the occlusion device, while careful procedural planning can ensure optimal device sizing and complete sealing of the appendage, even in the context of post-ablation tissue changes.

Source: European Heart Journal - Case Reports

DOI: 10.1093/ehjcr/ytaf627

Authors: Lukas Urbanek, David Schaack, Melanie A Gunawardene, K R Julian Chun, Boris Schmidt

Institutions: Agaplesion Markus Hospital, University Hospital Schleswig-Holstein, University of Lübeck, University Hospital Frankfurt

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $815