{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T16:33:39Z","timestamp":1793982819953,"version":"4.8.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T00:00:00Z","timestamp":1733529600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,28]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The congenital absence of the left atrial appendage (LAA) is an extremely rare anatomical anomaly, with only 23 cases documented in medical literature. The LAA plays a critical role in thrombus formation, particularly in patients with atrial fibrillation (AF), thus impacting stroke prevention strategies and the management of anticoagulation.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n We report a 48-year-old male with a 2-year history of hypertension and prior episodes of tachycardic palpitations, who presented with AF and chest pain. During catheter ablation for AF, a transoesophageal echocardiogram revealed the absence of the LAA, initially suspected to be a thrombus. The procedure was suspended until a computed tomography confirmed the congenital absence of the LAA. The patient successfully underwent pulmonary vein isolation with radiofrequency and, after a shared decision-making process, discontinued anticoagulation. He remains asymptomatic without AF recurrence.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n The congenital absence of the LAA raises important considerations for managing stroke risk in AF patients, as standard thromboembolic risk scores do not account for such anatomical variations. Despite the LAA being the most common site for thrombus formation, stroke risk in AF results from multiple factors beyond a single site of thrombus formation. Left atrial appendage occlusion is a viable alternative for stroke prevention in patients contraindicated for anticoagulation. Recent guidelines recommend individualized risk assessment using scores such as CHA2DS2-VA, even in atypical cases, ensuring that management strategies are tailored to each patient\u2019s risk profile.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae653","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T23:12:31Z","timestamp":1733872351000},"source":"Crossref","is-referenced-by-count":3,"title":["Congenital absence of the left atrial appendage: a positive coincidence for the electrophysiologist? A case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0900-3681","authenticated-orcid":false,"given":"Jo\u00e3o Gabriel","family":"Batista Lage","sequence":"first","affiliation":[{"name":"Electrophysiology Department, Rede D'Or S\u00e3o Luiz , R. Santo Amaro, 80 - Gl\u00f3ria, Rio de Janeiro - RJ, 22211-230 ,","place":["Brazil"]},{"name":"Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro , R. Prof. Rodolpho Paulo Rocco, 255 - Cidade Universit\u00e1ria, Rio de Janeiro - RJ, 21941-617 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Augusto Lethier","family":"Rangel","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Rede D'Or S\u00e3o Luiz , R. Santo Amaro, 80 - Gl\u00f3ria, Rio de Janeiro - RJ, 22211-230 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9964-6332","authenticated-orcid":false,"given":"Nilson Ara\u00fajo","family":"de Oliveira J\u00fanior","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Rede D'Or S\u00e3o Luiz , R. Santo Amaro, 80 - Gl\u00f3ria, Rio de Janeiro - RJ, 22211-230 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1144-9252","authenticated-orcid":false,"given":"Martha Valeria","family":"Tavares Pinheiro","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Rede D'Or S\u00e3o Luiz , R. Santo Amaro, 80 - Gl\u00f3ria, Rio de Janeiro - RJ, 22211-230 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8722-7504","authenticated-orcid":false,"given":"Olga Ferreira","family":"de Souza","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Rede D'Or S\u00e3o Luiz , R. Santo Amaro, 80 - Gl\u00f3ria, Rio de Janeiro - RJ, 22211-230 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,7]]},"reference":[{"key":"2024122016552266100_ytae653-B1","first-page":"215","article-title":"Congenital absence of the left atrial appendage: a case series","volume":"45","author":"Smith","year":"2022","journal-title":"J Cardiol"},{"key":"2024122016552266100_ytae653-B2","first-page":"1123","article-title":"The role of the left atrial appendage in atrial fibrillation: insights and clinical implications","volume":"18","author":"Brown","year":"2021","journal-title":"Heart Rhythm"},{"key":"2024122016552266100_ytae653-B3","first-page":"1364","article-title":"Imaging techniques in the detection of left atrial appendage anomalies","volume":"41","author":"Lee","year":"2020","journal-title":"Eur Heart J"},{"key":"2024122016552266100_ytae653-B4","first-page":"564","article-title":"Anticoagulation in patients with congenital cardiac anomalies: a review","volume":"139","author":"Wilson","year":"2019","journal-title":"Circulation"},{"key":"2024122016552266100_ytae653-B5","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024. ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae653\/60983349\/ytae653.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/12\/ytae653\/60983349\/ytae653.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/12\/ytae653\/60983349\/ytae653.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T16:55:33Z","timestamp":1734713733000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae653\/7918740"}},"subtitle":[],"editor":[{"given":"Rachel M A","family":"ter Bekke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ying Xuan","family":"Gue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Panteleimon E","family":"Papakonstantinou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Giorgia","family":"Benzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":5,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,11,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae653","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,11,28]]},"article-number":"ytae653"}}