Atrial Fibrillation Arising from the Left Atrial Appendage

Intern Med. 2015;54(24):3157-60. doi: 10.2169/internalmedicine.54.4146. Epub 2015 Dec 15.

Abstract

A 63-year-old patient presented for curative treatment of drug-resistant paroxysmal atrial fibrillation (AF). After pulmonary vein antrum isolation was achieved, AF could be still induced and persisted, while rapid activation at the left atrial appendage was conducted to the left atrium in a decremental conduction manner. A step-wise incremental discrete radiofrequency energy application at the ostium of left atrial appendage completely eliminated the AF. Neither AF nor atrial tachyarrhythmias reappeared, even under isoproterenol infusion and vigorous rapid atrial stimulations. The patient has experienced no symptoms or exhibited ECG evidence of AF during a 6-month follow-up.

Publication types

  • Case Reports

MeSH terms

  • Atrial Appendage / physiopathology*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology*
  • Atrial Fibrillation / therapy
  • Cardiac Electrophysiology*
  • Catheter Ablation / methods*
  • Follow-Up Studies
  • Heart Atria / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Veins / surgery
  • Tachycardia
  • Treatment Outcome