DR MILES DALBY

Patients with atrial fibrillation are at increaed risk of stroke due to blood clot formation in the left atrium of the heart which doesn’t pump properly. The most important place for clot formation appears to be a small outpouching known as the left atrial appendage (LAA). The risk of stroke from blood clots in AF can be reduced by thinning the blood (anticoagulation) which is regarded as the first line approach and has much evidence to support it.

Some patients however are intolerant of anticoagulation, usually due to bleeding. An alternative to anticaogulation for stroke prevention in AF is to ‘plug’ the LAA with an occlusion device so that it is no longer a site for clot development. This approach is less well established than anticoagulation but can be useful for some patients.

To perform a LAA oclusion procedure a catheter is passed through the vein in the groin (femoral vein) into the right atrium. The atrial septum is then crossed using a fine needle and a catheter passed into the left atrium. The LAA occlusion device is then deployed into the LAA and the catheter removed.