Relevance of electrical connectivity between the coronary sinus and the left atrial appendage for the intentional electrical isolation of the left atrial.

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Presentation transcript:

Relevance of electrical connectivity between the coronary sinus and the left atrial appendage for the intentional electrical isolation of the left atrial appendage in treating persistent atrial fibrillation: Insights from the LEIO-AF study Mokhtar Ibrahim, MRCP, PhD, Sandeep Panikker, MRCP, PhD, Eric Lim, MRCP, Vias Markides, FRCP, MD, Tom Wong, FRCP, MD, FHRS HeartRhythm Case Reports Volume 4, Issue 9, Pages 420-424 (September 2018) DOI: 10.1016/j.hrcr.2018.06.007 Copyright © 2018 Terms and Conditions

Figure 1 Case 1. A: Contrast was used to define the LAA. B: The Lasso catheter is situated at the LAA os. C: Circumferential ablation was performed along the atrial aspect of the LAA (CARTO anatomical shell, left lateral view). LAA os = left atrial appendage ostium. HeartRhythm Case Reports 2018 4, 420-424DOI: (10.1016/j.hrcr.2018.06.007) Copyright © 2018 Terms and Conditions

Figure 2 Case 1. A: Recordings after pulmonary vein isolation and linear ablation. B: Recording after initial endocardial LAA ablation. C, E: Ablation within atrial branch of the CS (white arrow). D: Isolation of the LAA. CS = coronary sinus; LAA = left atrial appendage; LAO = left anterior oblique. HeartRhythm Case Reports 2018 4, 420-424DOI: (10.1016/j.hrcr.2018.06.007) Copyright © 2018 Terms and Conditions

Figure 3 Case 2. A: Recordings after pulmonary vein isolation and linear ablation. B: Recording after initial endocardial LAA ablation. C: Isolation was not durable (reconnection). D, E: Radiofrequency delivery in the mid-distal CS (panel E, white arrow) led to the isolation of the LAA (panel D). CS = coronary sinus; LAA = left atrial appendage; LAO = left anterior oblique. HeartRhythm Case Reports 2018 4, 420-424DOI: (10.1016/j.hrcr.2018.06.007) Copyright © 2018 Terms and Conditions