Patients with atrial fibrillation and at risk of strokes now have more choice. Recent developments in medical devices allow doctors to undertake a procedure called left atrial appendage occlusion. The procedure involves placing a small plug or cover inside the heart to occlude the area that is responsible for producing blood clots and strokes. Left atrial appendage occlusion can be performed as minimally invasive surgery, usually with only an overnight stay in hospital.
Recent research has shown that left atrial appendage occlusion is as effective, if not better, as warfarin. This could be for a number of reasons but the most obvious is the difficulty in maintaining the regular INR level with warfarin, thus favouring left atrial appendage occlusion.
The major advantage of left atrial appendage occlusion is that it is a single treatment that will last a lifetime compared to taking daily anticoagulation tablets and in some cases needing regular blood tests. The other advantage is that it eliminates the added bleeding risk of the blood thinners.
Left atrial appendage occlusion is currently only offered to a limited number of patients on the NHS and only for patients that are at both high risk of stroke and bleeding complications. An example of such patients would be those that have recovered from a stoke but had life threatening bleeding with warfarin necessitating the need to cease warfarin treatment.
We hope that with time the advantages of left atrial appendage will become more apparent such that patients who choose not to take oral anticoagulant tablets will be offered this revolutionary procedure.
More information about this procedure is available here.