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Congenital Absence of Left Atrial Appendage RAPHAEL ROSSO, M.D., DOV VEXLER, M.D., SAMI VISKIN, M.D., and GALIT AVIRAM, M.D. From the Departments of Cardiology and Radiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

atrial fibrillation, congenital heart disease, left atrial appendage, stroke, catheter ablation A 62-year-old male patient with symptomatic, drug refractory paroxysmal atrial fibrillation was referred for radiofrequency ablation. His medical history was otherwise negative; specifically, he had no history of heart or chest surgery. Cardiac computerized tomography (CT) was performed the day before the procedure to merge the left atrial CT with the CARTO electro-anatomical mapping system. The

CT showed 2 pairs of pulmonary for the septal and lateral side without visualization of the left atrial appendage (Fig. 1 panel A, B). A transesophageal echocardiogram confirmed the absence of left atrial appendage. The patient underwent an atrial fibrillation ablation without complications. The risk of embolic events in patients with atrial fibrillation with congenital absence of left atrial appendage is intuitively low, but is actually unclear.

Figure 1. Panel A three-dimensional reconstruction of the left atrium, panel B cardiac computed tomography angiography of the left atrium.

J Cardiovasc Electrophysiol, Vol. 25, p. 795, July 2014. No disclosures. Address for correspondence: Raphael Rosso, M.D., Atrial Fibrillation Service, Departments of Cardiology and Radiology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Weizman 6, Tel Aviv 64239, Israel. Fax: +972-3-692-5762; E-mail: [email protected] Manuscript received 15 January 2014; Revised manuscript received 23 January 2014; Accepted for publication 24 January 2014. doi: 10.1111/jce.12383

Congenital absence of left atrial appendage.

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