Open AccessCardiac embolism after implantable cardiac defibrillator shock in non-anticoagulated atrial fibrillation: The role of left atrial appendage occlusion
Author(s) -
Xavier Freixa,
Rut Andrea,
Victoria Martín-Yuste,
Diego Fernández-Rodríguez,
Salvatore Brugaletta,
Mónica Masotti,
Manel Sabaté
Publication year - 2014
Publication title -
world journal of cardiology
Language(s) - English
Resource type - Journals
ISSN - 1949-8462
DOI - 10.4330/wjc.v6.i4.213
Subject(s) - medicine , contraindication , atrial fibrillation , cardiology , thrombus , left atrial appendage occlusion , shock (circulatory) , embolism , occlusion , percutaneous , warfarin , alternative medicine , pathology
Cardioembolic events are one of the most feared complications in patients with non-valvular atrial fibrillation (NVAF) and a formal contraindication to oral anticoagulation (OAC). The present case report describes a case of massive peripheral embolism after an implantable cardiac defibrillator (ICD) shock in a patient with NVAF and a formal contraindication to OAC due to previous intracranial hemorrhage. In order to reduce the risk of future cardioembolic events, the patient underwent percutaneous left atrial appendage (LAA) occlusion. A 25 mm Amplatzer™ Amulet was implanted and the patient was discharged the following day without complications. The potential risk of thrombus dislodgement after an electrical shock in patients with NVAF and no anticoagulation constitutes a particular scenario that might be associated with an additional cardioembolic risk. Although LAA occlusion is a relatively new technique, its usage is rapidly expanding worldwide and constitutes a very valid alternative for patients with NVAF and a formal contraindication to OAC.