Concomitant Pulsed Field Ablation and Left Atrial Appendage Occlusion for Atrial Fibrillation With Dextrocardia

作者：Gangbin Chen, Guizhou Ma, ChuMin Ni, Xinjie He, Zhixiong Cai · 发表于：JACC Case Reports · 年份：2026 · DOI：10.1016/j.jaccas.2026.109178 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac Arrhythmias and Treatments、Pericarditis and Cardiac Tamponade

BACKGROUND: Dextrocardia is a rare structural abnormality that poses challenge to interventional procedures of atrial fibrillation (AF). Concomitant ablation and left atrial appendage (LAA) occlusion offers a single-procedure approach for rhythm control and thromboembolic risk reduction in select patients with AF. Pulsed field ablation (PFA) may offer advantages in concomitant procedures in dextrocardia; however, available data remain limited. CASE SUMMARY: A 61-year-old man with dextrocardia presented with symptomatic paroxysmal AF. PFA and LAA occlusion were successfully performed guided by multimodal imaging. At 3-month follow-up, no arrhythmia and complete LAA seal was detected. DISCUSSION: PFA did not significantly alter the LAA landing zone diameter despite that proximal ridge edema was observed. Intracardiac echocardiography offers significant advantages during the combined procedures. TAKE-HOME MESSAGES: PFA-based pulmonary vein isolation combined with LAA occlusion guided by intracardiac echocardiography is a feasible and safe choice for AF with dextrocardia. PFA could induce pulmonary ridge edema but did not affect LAA landing zone dimension.