Managing Migrated Left Atrial Appendage Closure Devices in the Left Ventricle.

A 59-year-old woman with a pacemaker for paroxysmal atrial fibrillation developed left hemiparesis secondary to occlusion of the right middle cerebral artery. Following hybrid radiofrequency ablation and left atrial appendage occlusion, acute hypotension occurred due to device migration into the left ventricle. Optimal approach selection remains a significant clinical challenge.