Immediate Cardioversion During Left Atrial Appendage Occlusion in Three Patients With Left Atrial Appendage Thrombus.
Abstract
Purpose
We report the first cases of direct current cardioversion (DCCV) performed during percutaneous left atrial appendage occlusion (LAAO) in patients with left atrial appendage thrombus and assess its technical feasibility.
Methods
Three patients with left atrial appendage thrombus and absolute indications for LAAO underwent DCCV during the procedure because of hemodynamic instability from rapid atrial fibrillation.
Results
A single 200-J shock restored sinus rhythm in all patients. No device migration, embolization, significant peridevice leak, or neurologic events occurred. Follow-up imaging confirmed stable device position.
Conclusions
DCCV during LAAO appears technically feasible in selected patients, although larger studies are needed to confirm safety.