Introduction

Left atrial ridge (LAR)—also recognized as coumadin ridge—is the protruded convergence of left atrial appendage (LAA) and left pulmonary veins (PV). LAR is also a potential arrhythmogenic site, where embedding Bachmann’s bundle and close to the ligament of Marshall (1). LAR had long been a site for atrial fibrillation (AF) ablation (2) and one of the differential diagnosis of high-echo band on echocardiography (3).
Since 2012, combining catheter ablation with left atrial appendage closure (LAAC) has been reported as a promising therapy for AF patients (4). Thenceforth, several centres worldwide have reported considerable efficacy and safety of combined procedure (5-7). Of note, prominent acute LAR lesion after combined procedure has been reported by some studies (8,9). Such phenomenon has raised the concern about its impact on LAAC procedure and overall clinical prognosis. However, neither the feature of such lesion has been quantitatively evaluated nor its influence on combined procedure has been elucidated.
Hence, we aimed to innovatively explore the influence of acute LAR lesion on combined procedure through quantitively evaluating the peri-procedural and follow-up LAR profile on transesophageal echocardiography (TEE), and analyze its relationship with preprocedural information and follow-up outcomes.