Double Trouble: A Bifid Left Atrial Appendage Requiring a Double Lobe-and-Disk Device Approach

• LAAO devices are used for patients with AF intolerant of anticoagulation. • Periprocedural multimodality imaging is crucial for successful device deployment. • LAAs with bifid morphologies are uncommon and pose procedural challenges. • We describe closure of a bifid LAA using 2 side-by-side lobe-and-disk devices.