Lowering the risk of stroke for AFib patients
Atrial fibrillation (AFib) can cause symptoms that significantly erode your quality of life. It can also substantially increase your risk for stroke – a devastating complication that can change your life forever. Your electrophysiologist will work with you to determine your individual risk for stroke and formulate a comprehensive treatment plan to reduce that risk.
At Kansas City Heart Rhythm Institute, our experienced electrophysiologists will collaborate to develop a stroke prevention plan based on the latest research and using the most advanced electrophysiology procedures and therapies. If you have a significant stroke risk or unable to take blood thinners, a method of left atrial appendage (LAA) closure may be recommended.
Why choose KCHRI?
- Leaders in LAA Closure Research – Our electrophysiologists have authored numerous publications and have been primary investigators on clinical trials and EP studies shaping the future of LAA occlusion
- Access to New Investigational Treatments – Access to new technological advances and electrophysiology procedures that are not available yet at other facilities
Learn more about the Kansas City Heart Rhythm Institute. To make an appointment and see if this electrophysiology procedure may be right for you, call:
What is LAA closure?
AFib can produce an irregular heartbeat that causes blood to pool and form clots. Many of these blood clots originate in the left atrial appendage of the heart.
The LAA is a small sac-like appendage in the upper left chamber of the heart. During an LAA closure procedure, the atrial appendage is sealed so blood clots are unable to exit. This reduces the risk of stroke without the need for blood thinners.
There are multiple LAA occlusion devices including:
- WATCHMAN™
- AtriClip
- LARIAT
- And other investigational therapies
WATCHMAN™
Watchman™ left atrial appendage occlusion is a one-time, minimally invasive, catheter-based electrophysiology procedure. It is performed in the cardiac catheter lab and you will be under general anesthesia.
During the electrophysiology procedure, your cardiac electrophysiologist will insert a catheter (a thin, flexible tube) into the femoral vein in the groin. It is then threaded up to the heart and over to the left upper chamber. Fluoroscopy (a moving x-ray), contrast dye, and transesophageal echocardiogram (TEE)(ultrasound) are used to visualize the procedure and measure the left atrial appendage. Your electrophysiologist will then choose a Watchman size and deploy the device via the catheter. The device is then tested to make sure it fits securely and positioning is confirmed.
Procedure time: About 1 hour
Hospital Stay: Overnight for monitoring
Follow-up Care: You will need to take warfarin and aspirin for about 45 days or until the LAA is sealed (the lining of the heart grows over it). This will be confirmed by a transesophageal echo.
AtriClip
This is a minimally invasive surgical approach to permanently close the left atrial appendage. The AtriClip is a clamp-like device that is placed on the outside of your LAA to shut it and prevent blood from entering. This electrophysiology procedure is performed by a cardiothoracic surgeon.
Procedure time: About 1-3 hours
Hospital Stay: Overnight for monitoring
Follow-up Care: You will have a follow-up appointment about 45 days following the procedure.
LARIAT
LARIAT left atrial appendage ligation is a one-time, minimally invasive, catheter-based procedure. During the electrophysiology procedure, your doctor will guide two catheters with small magnets up to your heart and to the LAA. One catheter will be inside your heart and one will be outside to ensure proper placement. Then your cardiac electrophysiologist will use a lasso-like suture delivery device to close the left atrial appendage. The closure will eliminate blood flow to the LAA and overtime it will disappear.
Clinical Trial
Study Name: Amaze
Sponsor: SentreHeart
Amaze is an EP study to evaluate the safety and effectiveness of the LARIAT suture delivery system to percutaneously isolate and ligate the LAA from the left atrium as an adjunct to a planned pulmonary vein isolation (PVI) catheter ablation in persistent or longstanding persistent conditions.
EP Study Primary Investigator – Dhanunjaya Lakkireddy, MD
Facilities – Overland Park Regional Medical Center, Research Medical Center
Amulet™
Amulet™ is a new minimally invasive, catheter-based electrophysiology procedure that is currently seeking FDA approval. Like Watchman, this electrophysiology procedure also uses X-ray and ultrasound guidance to visualize and measure the appendage. The device is deployed via catheter and is tested to confirm fit and positioning.
Clinical Trial
Study Name: Amulet™
Sponsor: Abbott
Amulet™ is an EP study to determine if the Amulet device is safer and more effective when compared to the Watchman device.
EP Study Primary Investigator – Dhanunjaya Lakkireddy, MD
Facilities – Overland Park Regional Medical Center, Research Medical Center
Study name: Catalyst
Sponsor: Abbott
The objective of the Catalyst EP study trial is to evaluate the safety and effectiveness of the Amulet LAA occluder compared to non-vitamin K antagonist oral anticoagulant (NOAC) therapy in patients with non-valvular AFib at increased risk for ischemic stroke and who are recommended for long-term NOAC therapy.
EP Study Primary Investigator – Dhanunjaya Lakkireddy, MD
Facilities – Overland Park Regional Medical Center, Research Medical Center
Is LAA closure right for me?
LAA closure is for patients who:
- Cannot take blood thinners due to brain bleed or brain aneurism
- Cannot be on blood thinners for very long due to a high bleeding risk because they are elderly, have Parkinson’s disease, stability issues, or bleeding issues in their bladder or elsewhere
LAA Closure Results
Left atrial appendage occlusion has been shown to significantly reduce a person’s risk of stroke. Talk to your electrophysiologist about the results you can expect.