Reducing the Risk of Stroke for People with Non-Valvular Atrial Fibrillation
For the millions in America with atrial fibrillation, a type of abnormal heartbeat, treatment has traditionally included lifelong medication therapy to reduce stroke risk. An implantable device available through The Heart Center at Northeast Georgia Medical Center (NGMC) is providing an innovative alternative.
More than 2.7 million Americans have been diagnosed with atrial fibrillation, which is often called AFib. The condition occurs when the upper chambers of the heart—called the atria—beat irregularly, which disrupts blood flow in the heart.
“Atrial fibrillation typically causes a fast and irregular heartbeat and significantly increases the risk of stroke by promoting blood clots that form predominantly in an area of the left atrium called the left atrial appendage,” says Joon Ahn, MD, FACC, FHRS, cardiologist and electrophysiologist at The Heart Center of NGMC. “Patients commonly develop symptoms of heart fluttering or palpitations, fatigue, shortness of breath, chest discomfort, dizziness, or increased leg or ankle swelling.”
Because atrial fibrillation causes abnormal, weaker contractions of the heart, blood pools in the heart and can form blood clots. If a clot leaves the heart and travels to the brain, it can block the flow of blood through the arteries, causing a stroke. As a result, those with atrial fibrillation are five times more likely than the general population to suffer a stroke.
- Joon Ahn, MD
- Salem Sayar, MD, FACC
Surveying the treatment options
Treatment for atrial fibrillation has multiple goals, including restoring the heart to a normal rhythm, preventing heart failure and preventing blood clots.
When seeking to prevent blood clots and the associated risk of stroke in atrial fibrillation patients, the standard of care has long been long-term use of anticoagulant medications, such as warfarin. These medications are also known as blood thinners, and one of their side effects is an increased risk of bleeding. Because of this, careful monitoring and regular medical appointments are typically required, particularly with warfarin.
A new device, called the WATCHMAN™, which is implanted during a nonsurgical procedure, offers an alternative without the associated risks.
“The WATCHMAN is an implantable device that is inserted into the left atrial appendage through catheters that are inserted into a vein in the leg,” Dr. Ahn says. “The device plugs off and seals the left atrial appendage from the left atrium to prevent future clot formation.
“The innovative aspect of this procedure is the way that stroke risk is reduced by closing off the left atrial appendage, which eliminates the need for long-term anticoagulant therapy.”
Most patients with non-valvular atrial fibrillation are potential candidates for WATCHMAN implantation. This includes patients who are eligible for warfarin therapy, as well as those for whom anticoagulant therapy isn’t ideal, including those with a history of serious bleeding, frequent falling with injuries or intolerable side effects from the medications.
An Optimal Alternative
Before any type of medical treatment receives approval from the U.S. Food & Drug Administration, it undergoes comprehensive review through clinical trials. The WATCHMAN device was evaluated in four clinical trials, including two that compared its effectiveness with that of warfarin therapy.
“Clinical trials of the WATCHMAN device found no significant difference in the risk of stroke and embolism when compared with warfarin therapy,” Dr. Ahn says. “In fact, in a subgroup analysis, those who underwent WATCHMAN implantation saw a significant reduction in the risk of hemorrhagic stroke and improved quality of life compared with warfarin therapy.”
To request an appointment with a cardiologist at The Heart Center of NGMC, call 770-534-2020 or visit heartngmc.org/appointment.
Call the Heart & Vascular Services department at 770-219-5416 or send us a contact form for more information.