Discussion
To the best of our knowledge, this is the first report of the CB
ablation of focal AT originated in the tip of the LAA stump after LAA
ligation. Due to the complex anatomic structure of the surgical LAA
ligation stump, it is difficult to manipulate the catheter and deliver
the effective energy to the target. Moreover, the thinness and fragility
of the LAA stump increases the risks of cardiac perforation and
tamponade. Successful electrical isolations of both RAA and LAA with CBs
have been previously reported 4 5,
which suggests that cryo-ablation could be an alternative treatment for
these patients. However, LAA electrical isolation might increase the
thromboembolic risk 6, further, the risk of embolic
events increases in patients with incomplete surgical LAA ligation7. This case is especially at high thromboembolic risk
for both incomplete LAA ligation and LAA isolation. So we deem it
necessary that the patient take long-term anticoagulants. In conclusion,
the CB2 electrical isolation could
be safe and effective in treating focal AT originating in the tip of LAA
stump after LAA ligation.