1. Volume 15, Issue 12, Pages 1746-1753 (December 2018)
Electrical isolation of the left atrial appendage increases the risk of ischemic stroke and transient ischemic attack regardless of postisolation flow velocity 
Yun Gi Kim, MD, Jaemin Shim, MD, Suk-Kyu Oh, MD, Kwang-No Lee, MD, Jong-Il Choi, MD, Young-Hoon Kim, MD 
Heart Rhythm 
Volume 15, Issue 12, Pages (December 2018)
DOI: /j.hrthm
Copyright © 2018 The Authors Terms and Conditions

2. Figure 1
Flow diagram of the study. LAA = left atrial appendage; RFCA = radiofrequency catheter ablation; TIA = transient ischemic attack.
Heart Rhythm  , DOI: ( /j.hrthm )
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3. Figure 2
A clinical case of LAA isolation. A: Ablation lesion set of the patient. During first-time ablation, we performed 4 circumferential pulmonary vein isolation, roofline, anterior line, perimitral line, and CFAE-guided ablation. During the re-do procedure, ablation of the LAA anterior neck isolated the LAA. B: Significantly decreased contractility of the LAA was observed after electrical isolation. C: After LAA isolation, the average LAA flow velocity decreased from 41.5 to 25.5 cm/s. D: The patient experienced ischemic stroke with total occlusion of right middle cerebral artery while taking clopidogrel. The patient’s CHA2DS2-VASc score was 0. E: LAA occlusion therapy was performed to prevent further ischemic stroke events. CFAE = complex fractionated atrial electrogram; LAA = left atrial appendage; RFCA = radiofrequency catheter ablation.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2018 The Authors Terms and Conditions

4. Figure 3
Electrical isolation of the LAA and the risk of ischemic stroke or TIA. Electrical isolation of the LAA was associated with a significantly increased risk of ischemic stroke or TIA in both raw comparison (A) and propensity score–matched analysis (B). HR = hazard ratio; LAA = left atrial appendage; TIA = transient ischemic attack.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2018 The Authors Terms and Conditions

5. Figure 4
Effect of late recurrence on IS and TIA. Patients without late recurrence had a significantly lower risk of IS only if the LAA was not isolated, which suggests a moderator effect of LAA isolation. IS = ischemic stroke; LAA = left atrial appendage; LR = late recurrence; TIA = transient ischemic attack.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2018 The Authors Terms and Conditions

6. Figure 5
Effect of LAA isolation on LAA flow velocity. A: LAA flow velocity decreased significantly after LAA isolation. B: Post-LAA isolation LAA flow velocity did not differ between patients with and without ischemic stroke or TIA. LAA = left atrial appendage; TIA = transient ischemic attack.
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2018 The Authors Terms and Conditions

7. Supplemental Figure S1
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2018 The Authors Terms and Conditions

8. Supplemental Figure S2
Heart Rhythm  , DOI: ( /j.hrthm )
Copyright © 2018 The Authors Terms and Conditions