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Lowering the risk of stroke for afib patients
Atrial fibrillation 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 the Kansas City Heart Rhythm Institute at the HCA Midwest Health Heart and Vascular Institute, our experienced electrophysiologists will collaborate to develop a stroke prevention plan based on the latest research and using the most advanced therapies. If you have a significant stroke risk or unable to take blood thinners, a method of LAA closure may be recommended.
Why Choose KCHRI?
- Leaders in LAAC Research – Our electrophysiologists have authored numerous publications and have been primary investigators on clinical trials shaping the future of LAA occlusion
- Access to New Investigational Treatments – Access to new technological advances 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 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.
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 left atrial appendage occlusion devices including:
- WATCHMAN
- AtriClip
- LARIAT
- And other investigational therapies
WATCHMAN
Watchman left atrial appendage occlusion is a one-time, minimally invasive, catheter based procedure. It is performed in the cardiac cath lab and you will be under general anesthesia.
During the procedure, your electrophysiologist will insert a catheter (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 physician 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 confirm the positioning.
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 left 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 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 appointments about 45 days following the procedure.
LARIAT
Lariat left atrial appendage ligation is a one-time, minimally invasive, catheter based procedure. During the procedure, you EP 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 physician 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
A 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 PVI catheter ablation in persistent or longstanding persistent.
Primary Investigator – Dr. Dhanunjaya Lakkireddy
Facilities – Overland Park Regional, Research Medical Center
Amulet
This is a new minimally invasive, catheter based procedure that is currently seeking FDA approval. Like Watchman, this procedure also use x-ray and ultrasound guidance to visualize and measure the appendage. The device is deployed via a catheter and is tested to confirm fit and positioning.
Clinical Trial
Study Name: Amulet
Sponsor: Abbott
A study to determine if Amulet device is safe and effective when compared to Watchman device. Randomized 1:1 Watchman vs Amulet.
Primary Investigator – Dr. Dhanunjaya Lakkireddy
Facilities – Overland Park Regional, Research Medical Center
Study name: Catalyst
Sponsor: Abbott
The objective of this 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 AF at increased risk for ischemic stroke and who are recommended for long-term NOAC therapy.
Primary Investigator – Dr. Dhanunjaya Lakkireddy
Facilities – Overland Park Regional, Research Medical Center
Is LAA Closure Right for Me?
LAAC 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, stability issues or bleeding issues in their bladder or elsewhere
LAAC Results
Left atrial appendage occlusion has been show to significantly reduce a person’s risk of stroke. Talk to your electrophysiologist about the results you can expect.