Left atrial appendage (LAA) has been known as a source of focal atrial tachycardias (AT)。Radio-frequency (RF) energy based focal ablation of these arrhythmias was a common strategy in most cases. However, catheter ablation in these foci remains challenging due to the complexity of the LAA anatomy. Sometimes an epicardial approach is an alternative when endocardial ablation of LAA fails. Cryo-balloon based LAA isolation may be considered before epicardial access3。We report a patient with focal atrial tachycardia originated in the tip of a LAA ligation stump (he underwent a heart valve mitral bio-prostheses replacement and had his LAA ligated during the operation years ago), who, being refractory to focal RF ablation, received a LAA isolation using a cryo-balloon which successfully terminated the tachycardia and converted the patient to sinus rhythm.