Doctors at the Stony Brook Heart Institute Electrophysiology Lab are using a new nonsurgical technique called the LARIAT Suture Delivery Device to treat patients with atrial fibrillation, or A-Fib, who cannot tolerate blood thinning medication.
A-Fib is the most common heart rhythm disorder that causes the upper chambers of the heart to beat fast and erratically. An estimated 2.7 million Americans are living with the disorder, and if uncontrolled, can have serious consequences including stroke and early death. Currently the condition accounts for more than 20 percent of stroke-related deaths.
Patients are normally given blood thinners such as warfarin (Coumadin) and other anticoagulants to manage their condition by preventing blood clots. However patients must rigorously manage the level of the drugs in their blood. For most patients, these blood thinners are very effective in reducing the risk of stroke but there is a potential for bleeding which in some cases can be serious. For those individuals who cannot tolerate blood thinners due to prior bleeding or those who are at a high risk for bleeding, the LARIAT procedure can safely reduce the risk of stroke without any further bleeding risk.
The LARIAT procedure is a nonsurgical, minimally-invasive technique that uses sutures to tie off the left atrial appendage of the heart. This area of the heart is the primary source of blood clots leading to stroke in patients with atrial fibrillation.
With the patient under general anesthesia, physicians guide two catheters into the patient's heart to seal the left atrial appendage with a pre-tied suture loop -- similar to a lasso -- with the LARIAT device. Rather than a surgical procedure, the technique uses a needle to introduce catheters into the heart.
"In the past there weren't any alternatives that we could really offer these types of patients," said Roger Fan, MD, Associate Professor, Department of Medicine, Director of Arrhythmia Consult Service, "The LARIAT is a great alternative to the possibility of a lifetime of blood thinners which can have some serious side effects like GI bleeds, as well as an alternative to invasive open-heart surgery."
On December 3, 2013, Dr. Fan and his team at the Stony Brook Heart Institute completed their first LARIAT procedure without having to spread the ribcage or cut through bone to reach the heart.
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