Atrial fibrillation with a giant left atrial appendage can be successfully treated with pulmonary vein antrum isolation.

A congenital giant left atrial appendage (LAA) is a rare condition only described in case reports [1]. Supraventricular tachycardias, including atrial fibrillation (AF), and systemic embolisation are the most common clinical findings [1, 2]. Almost all reported cases are treated by resection of the giant LAA [1]. A few cases are treated conservatively [3, 4]. Catheter ablation has not been reported as a treatment option. For the first time, we present a patient with paroxysmal AF and a congenital giant LAA who was successfully treated by percutaneous pulmonary vein antrum isolation (PVAI).