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When you're diagnosed with atrial fibrillation (AFib), often the treatment involves options to reduce the risk of stroke, as well as treatment to manage or correct your abnormal heart rhythm. When the heart beats too rapidly, it can cause blood to pool in certain areas of the heart and increase the risk of blood clots that could cause a stroke.

For many with AFib, anticoagulants are prescribed to help reduce the risk. However, some with AFib may not be good candidates for anticoagulants. If this is the case, left atrial appendage closure may be recommended as an alternative to long-term medication.

What Is Left Atrial Appendage Closure?

Studies show that the vast majority of blood clots that form in those with AFib begin in a small pouch off the left atrium of the heart called the left atrial appendage. If the blood clots travel out of the left atrial appendage, they have the potential to cause a stroke.

"If you occlude the left atrial appendage, you can decrease the risk of a clot forming in a way that's similar to the effect of being on an anticoagulant medication every day," said Adam Shapira, MD, medical director of electrophysiology services at The Heart Hospital Baylor Plano.

Left atrial appendage closure seals off the appendage from the rest of the heart to prevent blood from pooling there and reduce the risk of clots.

Who Benefits from Left Atrial Appendage Closure?

Studies have shown that left atrial appendage closure provides approximately the same reduction in stroke risk as the use of anticoagulant medication. It may be beneficial to those who cannot take long-term anticoagulant medication because they:

  • Have conditions that put them at a higher risk of bleeding problems, such as previous head bleed or a condition that causes bleeding in the stomach
  • Are frail or have other lifestyle factors that increase the risk of falls that might cause bleeding
  • Are still having problems with blood clots despite blood thinning medication

"If you are on an anticoagulant and if you are having problems with that anticoagulant, this is a preventative treatment option that can be discussed with your physician," Dr. Shapira said.

Left Atrial Appendage Closure Options

Left atrial appendage closure may be performed surgically, where surgeons can suture, staple or place a clip on the appendage to seal it. The appendage also may be sealed using a special device and a procedure called left atrial appendage ligation.

Most recently, The Heart Hospital Baylor Plano was one of the first in the area to offer a new left atrial appendage occlusion device that is implanted during a procedure in the EP lab to seal off the appendage. The device is inserted through a small incision in the groin area up into the heart, similar to the placement of a stent. Most patients are able to go home the next day after the procedure.

"We've had success with the first device to market, but there are other occlusion devices that are being studied or will be studied," Dr. Shapira said. "We'll be involved in those trials to see if certain devices perform better than others."

Find Treatment for AFib

Find out more about treatment options for AFib, as well as left atrial appendage oc​​​clusion devices​, at The Heart Hospital Baylor Plano.​

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