The left atrial appendage (LAA) is a small sac located in the muscle wall of the left atrium, which is located in the top left chamber of the heart. Normally, when the heart contracts with each heartbeat, the blood in the left atrium and the LAA is squeezed out of the left atrium and into the left ventricle, which is located in the bottom left chamber of the heart.
What Is Atrial Fibrillation?
In the case of Atrial Fibrillation, the electrical impulses that control the heartbeat do not travel the way they’re supposed to, in an orderly fashion. Instead, many impulses happen all at once and spread through the atria in a chaotic manner. When this happens, the atria does not have enough time to contract and effectively squeeze blood into the ventricles, and because the LAA is a small sac, blood can collect there and form into clots in the LAA and the atria. Blood clots can cause a stroke, which is why people with the condition of Atrial Fibrillation are 5 to 7 times more likely to have a stroke than those without this condition.
Are There Any Treatments?
The common treatment for patients with Atrial Fibrillation has been taking blood thinners, the most common on being Warfarin. However, many patients have concerns about taking the drug as it requires frequent monitoring and can interact with other drugs and even food to cause an adverse reaction. These side-effects require several adjustments of the drug, and can become a hassle for many patients. There are other, newer medications such as Dabigatran, Rivaroxaban, and Apixaban available on the market, but they are suited for patients who do not have heart valve disease. However, like Warfarin, some patients have concerns and problems with these medications, including the potential high cost and maybe side effects.
What is the Alternative?
The procedure of Left Atrial Appendage Closure can be a welcome alternative to patients, as it can eliminate the need for long-term anticoagulation medication while helping to prevent the risk of stroke. Bumrungrad International performs this procedure using the WATCHMAN device, making it possible for patients to experience the benefits of this treatment right away.
What is the WATCHMAN?
The WATCHMAN device has been approved by the FDA:
To reduce the risk of thromboembolism from the LAA in patients with nonvalvular atrial fibrillation who are at increased risk of stroke or systemic embolism but are not candidate from long term anticoagulation as well as who have an appropriate reason to want treatment with non – medication alternative to warfarin.
The WATCHMAN Device is a parachute-shaped, self-expanding device that closes the LAA. It was tested in several studies that showed the device was a good alternative treatment for patients who cannot tolerate treatment with medication.
The WATCHMAN device is implanted percutaneously (through the skin) in the electrophysiology (EP) lab. The implant procedure does not require surgery; however, general anesthesia may be used during the procedure. A catheter sheath is inserted into a vein near the groin and guided across the septum, which is a muscular wall that divides the right and left sides of the heart to the opening of the LAA. The device is placed in the opening of the LAA. This seals off the LAA and keeps it from releasing clots.
Please be aware of the potential adverse events including, but not limited to: airway trauma, congestive heart failure, arrhythmias, deep vein thrombosis, excessive bleeding, fever, hypotension, Ischemic stroke, hemorrhagic stroke, respiratory insufficiency, or even death. There may also be other potential adverse events that are unforeseen at this time.
Heart (Cardiology) Center
Bumrungrad International Clinic (BIC) Building, 14th
Bumrungrad International Hospital, Bangkok, Thailand
Online Appointment: Make appointment here