Interatrial Stent to Treat Stiff Left Atrium Syndrome

Background: Catheter ablation for atrial fibrillation (CAAF) can result in stiff left atrial syndrome (SLAS) in up to 8% of patients. SLAS can be challenging to diagnose and difficult to distinguish from heart failure with preserved ejection fraction (HFpEF), presenting with similar signs and symptoms.

Case presentation: We report the first case of using an interatrial stent to maintain therapeutic benefit of atrial septostomy in a patient with symptomatic SLAS. While interatrial shunt devices have preliminarily been shown to be safe and efficacious for the treatment of HFpEF, their utilization in those with SLAS has not previously been described [1].

Conclusions: In patients with prior CAAF, SLAS should be considered to explain dyspnea when alternative processes have been excluded. Treatment of SLAS can be challenging with medical therapy alone, and septostomy may provide significant symptomatic benefit in these patients. Interatrial stenting can improve the patency of such interventions.