Left Atrial Appendage Closure Can Be Key to Preventing Strokes
On August 31, the electrophysiology team at White Plains Hospital marked another milestone by successfully implanting a WATCHMAN device in the first of a long list of patients. The procedure represents a real game-changer for atrial fibrillation (AFib) patients who are at risk of stroke but are not well-suited to the standard treatment: lifetime doses of anticoagulant medicines to thin the blood.
First, let’s start with the problem. AFib is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. With at least 2.7 million Americans living with AFib, according to the American Heart Association, the condition is one of our generation’s biggest health concerns; it also increases the risk of stroke fivefold and, as we know, suffering a stroke can be devastating, paralyzing, and/or lethal.
The medical community has been battling AFib, and strokes caused by AFib, for decades. Blood-thinning medications, when carefully and specifically prescribed for each individual, have been revolutionary in preventing strokes caused by AFib – so much so that they have saved lives.
However, the No. 1 problem with blood thinners is, of course, bleeding. Patients prone to bleeding historically have been faced with a double whammy. They can take blood thinners to avoid a stroke, which increases their chance for abnormal bleeding due to a number of causes (frequent falls, anemia, kidney failure, gastrointestinal issues, among others), or they do not take the blood thinner and face an increased possibility of a stroke. It truly can be a difficult choice for such patients.
And that is where our latest procedure, known as left atrial appendage closure (LAAC), comes in. LAAC is a minimally invasive procedure that requires a tremendous amount of expertise; it involves the implantation of a stent-like filter that specifically closes off the heart’s left atrial appendage, thereby preventing blood clots from escaping into the bloodstream resulting in a stroke or embolism.
Thanks to continuing advances in science and technology, an LAAC can be beneficial to a qualifying patient population. I have been fortunate to perform this cutting-edge treatment at other institutions, and am elated that we can now offer LAAC at White Plains Hospital. Dr. Luigi Di Biase, an international authority in the field, has been instrumental in helping us get to this point.
This development follows a number of exciting new cardiac procedures offered at White Plains Hospital, including the additions of catheter ablation of atrial fibrillation and, just a few months ago, open-heart surgery. The successful launch of these programs epitomizes the power of collaboration between the Hospital and Montefiore.
In closing, I would like to re-emphasize that an LAAC is not for everyone with AFib; blood thinners are still Plan A for those without high risk of bleeding. But for the appropriate candidate, an LAAC can truly be transformative.