Pulsed-Field-Ablation for Atrial Fibrillation in a Patient With Left Atrial Appendage Occlusion Device

Pulse-field ablation (PFA) is increasingly utilised for pulmonary vein isolation in the management of atrial fibrillation, as are left atrial appendage occlusion devices (LAAO). Previously, radiofrequency ablation in patients with LAAO devices has been performed, however, PFA after the insertion of LAAO has not been described [1]. Simultaneous sequential PFA followed by insertion of LAAO device has previously been performed without complications [2,3]. To our knowledge, we report the first case of PFA using the Farapulse system (Boston Scientific, CA, USA) with a pre-existing Amplazter Amulet LAAO device (Abbott, Chicago, IL, USA), in a 51-year-old male, who had this LAAO device inserted in March 2023 due to a history of persistent atrial fibrillation complicated by long-standing gastrointestinal bleeding and left middle cerebral artery stroke.