AFib Patients Have New Option to Reduce Stroke Risk

February 14, 2013

 

Lariat Team at Mercy

Lariat Team at Mercy Heart and Vascular.

From left: Dr. Anthony Sonn, Dr. Clark McKenzie, 

Dr. Mauricio Sanchez and Dr. Amit Doshi.

ST. LOUIS – Approximately 6 million U.S. adults have been diagnosed with atrial fibrillation (AFib), a condition characterized by rapid and irregular heartbeat and a high risk of heart failure and stroke. One-quarter of all strokes in the elderly are attributed to AFib but there is now a new option for stroke prevention in the area.

On Feb. 13, cardiologists at Mercy Hospital St. Louis were the first in Missouri to perform a non-surgical procedure using sutures to tie off a left atrial appendage (LAA), which is the source of blood clots leading to stroke in patients with atrial fibrillation (AFib). 

With the patient under general anesthesia, the physicians guided two catheters into the patient’s heart to seal the LAA with a pre-tied suture loop. Each procedure is completed by a team including an electrophysiologist and interventional cardiologist along with supporting clinicians. The team consists of electrophysiologists Mauricio Sanchez, MD and Amit Doshi, MD and interventional cardiologists Anthony Sonn, MD and Clark McKenzie, MD, all with Mercy Clinic Heart and Vascular.

“The technique is a safe alternative for AFib patients at high risk for stroke who can’t be on blood thinners due to history of bleeds or a high fall risk,” Dr. Sanchez said.

“This procedure has the potential to save many lives,” Dr. Sonn said. “AFib patients who can’t be on blood thinners to prevent stroke risk now have an option. Before this procedure, they would be on an aspirin a day and take their chances.”

The majority of AFib patients take warfarin because left untreated, AFib can cause life-threatening blood clots leading to stroke. Approximately 25-30 percent of patients with AFib have contraindications to the drug – such as concerns of falling or imbalance in elderly patients – and, for those who can take it, only about 55-60 percent receive warfarin.

Those who do take warfarin must rigorously manage the drug’s level in their blood. High levels can cause excessive or internal bleeding, even after minor falls, bruises, or cuts. For some, this management regime can mean monthly tests over the course of many years. In eliminating the need to take warfarin, the LAA procedure can reduce the need for frequent medical visits. 

Mercy is also in the second phase of the PREVAIL clinical trial - one of the leading trial sites nationally - comparing the WATCHMAN® Left Atrial Appendage Closure Device to long-term warfarin therapy, another option for some patients with AFib. This phase of the trial allows all patients who meet the criteria to have the WATCHMAN® Device implant without being randomized to warfarin therapy alone.

Mercy Hospital St. Louis, part of Mercy’s east Missouri region, is a 979-bed comprehensive teaching hospital. The 80-acre site houses a nine-level heart and vascular hospital, a cancer center; a comprehensive children's hospital; a surgery center; and a 120-bed skilled nursing center.

Mercy is the sixth largest Catholic health care system in the U.S. and serves more than 3 million people annually. Mercy includes 32 hospitals, 300 outpatient facilities, 38,000 co-workers and 1,900 integrated physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas. In Mercy’s east Missouri region, services include a 979-bed hospital in St. Louis, 187-bed hospital in Washington, 251-bed hospital in Festus and Mercy Clinic, a 570-member multispecialty physician organization.

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