LEFT ATRIAL APPENDAGE OCCLUSION

STROKE RISK FROM AF

During atrial fibrillation the upper chambers of the heart quiver rapidly instead of their normal pumping action, which may allow blood to stagnate, and blood clots to form inside the heart. 

The majority of blood clots form within a blind-ending pocket called the left atrial appendage (LAA) attached to the left upper chamber.  If a blood clot dislodges and travels to the brain a stroke may result.

LEFT ATRIAL APPENDAGE OCCLUSION

Left atrial appendage occluder devices are an alternative treatment to taking long term oral anticoagulation to prevent stroke (although not if you have 'Valvular AF'). 

 

This involves a keyhole catheterisation procedure to deliver a small “plug” inside the heart to seal off the blind-ending pocket (left atrial appendage) where blood clots are known to form. 

 

 

 

Once the plug has healed in properly (around 2 months) then anticoagulation can be stopped.  The use of anticoagulant or antiplatelet medications (such as Aspirin and/ or Clopidogrel) after the implant is individualized for each patient.

 

These devices are an excellent option for people who are completely contraindicated for anticoagulation treatments due to bleeding problems or other medical conditions that prevent them from taking blood thinnners. 

Animation of left atrial appendage device occlusion procedure and healing

HOW EFFECTIVE IS THE TREATMENT?

Left atrial appendage device occlusion with the Watchman device has been shown to be as efficacious as oral anticoagulation for preventing strokes in AF, but is associated with lower risk of long term bleeding.

However it is important to remember that less than one quarter of all strokes are caused by AF.  In fact, the majority of strokes result from hardening of the arteries (atherosclerosis) leading to the brain and the effects of high blood pressure and these types of strokes can also affect patients with AF.       

 

Although no treatment is 100% effective, patients with AF can significantly reduce their chances of having a stroke with appropriate therapy which now includes bloodthinners or left atrial appendage occlusion devices.