Spectrum Health Uses Minimally Invasive Approach To Avoid Stroke In Some Atrial Fibrillation Patients

Cardiologists at Spectrum Health’s Fred and Lena Meijer Heart Center were the first in West Michigan to perform a minimally invasive procedure to tie off a left atrial appendage (LAA), which can be a source of blood clots leading to stroke in patients with atrial fibrillation (AFib).

Approximately six million U.S. adults have been diagnosed with AFib, which is an arrhythmia or irregular heartbeat. One-quarter of all strokes in the elderly are attributed to AFib but there is now a new option for stroke prevention in the area.

AFib is the most common cardiac arrhythmia, characterized by rapid and irregular heartbeat, chest discomfort and shortness of breath. It is also known to be associated with an increased risk of stroke with the LAA being the main source of those strokes.

“This procedure is a safe alternative for AFib patients at high risk for stroke who can’t be on blood thinners due to a history of bleeds or a high fall risk,” said Spectrum Health electrophysiologist Bohuslav Finta, MD. Finta performed Spectrum Health’s first Lariat procedure with interventional cardiologist H. Paul Singh, M.D., who is a partner in the West Michigan Cardiology practice.

“The LAA is a blind sack that extends from one of the top chambers of the heart,” said Finta. “It serves no real purpose but can form clots in people with arrhythmias.”

In AFib, the LAA can stop contracting and the stationary blood inside can turn into a clot. If pieces of the clot break off, they can be pumped to the brain and cause a blockage of the blood vessels resulting in a stroke.

This procedure, using the LARIAT® Suture Delivery Device, works as a lasso that goes around the LAA and stops the flow of blood to that area where blood clots form, explained Finta. With the patient under general anesthesia, the physicians guide two catheters into the patient’s heart to tie off and seal the LAA with a pre-tied suture loop.

A similar procedure has been done surgically for many years during open-heart surgery for other issues, such as a bypass or valve repair. However, this minimally invasive procedure, using equipment developed by SentreHEART, Inc.
“This procedure has the potential to save lives,” Finta said. “AFib patients who can’t be on blood thinners such as warfarin to prevent stroke risk now have another option.”

The majority of AFib patients take warfarin because left untreated, AFib can cause life-threatening blood clots leading to stroke. Unfortunately, approximately 25-30 percent of patients with AFib have contraindications to the warfarin and other similar drugs aimed at prevention of clots. These contraindications include prior serious bleeding, concerns of falling or imbalance in elderly patients, or use other medications which can increase risk of life-threatening bleeding. It is estimated that only about 55-60 percent of AFib patients who need stroke prevention receive warfarin, said Finta.

Spectrum Health is a not-for-profit health system in West Michigan offering a full continuum of care through the Spectrum Health Hospital Group, which is comprised of nine hospitals including Helen DeVos Children’s Hospital, a state of the art children’s hospital that opened in January 2011, and 140 service sites; the Spectrum Health Medical Group and West Michigan Heart, physician groups totaling more than 700 providers; and Priority Health, a health plan with 600,000 members. Spectrum Health is West Michigan’s largest employer with 19,000 employees. The organization provided $204 million in community benefit during its 2012 fiscal year.