Abstract
Left atrial appendage occlusion has become an important minimally invasive treatment option for patients with atrial fibrillation who previously interrupted or permanently discontinued oral anticoagulation due to bleeding risks or complications. The effectiveness of the therapy relies on the safety of device deployment and the complete closure of the left atrial appendage (LAA) with no peridevice leaks. The variability of the LAA anatomy seen on preprocedural imaging requires a tailored approach for successful exclusion. We hereby present a patient with a large multilobar LAA that required 2 simultaneous Amulet devices to achieve complete exclusion of the appendage.