ArticleJACC. Case reports2026
Concomitant Pulsed Field Ablation and Left Atrial Appendage Occlusion for Atrial Fibrillation With Dextrocardia.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDextrocardia is a rare structural abnormality that poses challenge to interventional procedures of atrial fibrillation (AF). Concomitant ablation and left atrial appendage (LAA) occlusion offers a single-procedure approach for rhythm control and thromboembolic risk reduction in select patients with AF. Pulsed field ablation (PFA) may offer advantages in concomitant procedures in dextrocardia; however, available data remain limited. CASE SUMMARY: A 61-year-old man with dextrocardia presented with symptomatic paroxysmal AF. PFA and LAA occlusion were successfully performed guided by multimodal imaging. At 3-month follow-up, no arrhythmia and complete LAA seal was detected. DISCUSSION: PFA did not significantly alter the LAA landing zone diameter despite that proximal ridge edema was observed. Intracardiac echocardiography offers significant advantages during the combined procedures. TAKE-HOME MESSAGES: PFA-based pulmonary vein isolation combined with LAA occlusion guided by intracardiac echocardiography is a feasible and safe choice for AF with dextrocardia. PFA could induce pulmonary ridge edema but did not affect LAA landing zone dimension.
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