Request an Appointment



Contact us with Questions

Expand Content

2013 Spring AFIB Stroke Prevention: Innovative Devices Expand Treatment Options

We now know that patients with atrial fibrillation (a-fib) are five times more likely to suffer a stroke, which means that risk reduction has taken center stage. Newer oral anticoagulants and enhanced surgical techniques have provided more treatment options than ever before - and when it comes to medical devices, a new era is dawning.

“Device implants are becoming an attractive option for reducing the risk of stroke without the need to be on anticoagulation and in patients who are at high risk of bleeding while on anticoagulants,” says Walid Saliba, MD, Director of the Electrophysiology Lab in the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic.

Three innovative devices are currently under investigation or newly approved:

Watchman® (Boston Scientific) is a device designed to close off the left atrial appendage (LAA) to reduce the risk of stroke. Currently in its last phase of investigation, Dr. Saliba says that many hope that the device will receive FDA approval within a matter of months.

"The good thing about Watchman is that so far it is the only device that has been looked at in a large clinical trial and has been shown to be equal—if not superior—to warfarin for stroke reduction," he says. Patients who receive the device would only need to take warfarin for 45 days after the implant.

"The procedure is a fairly easy one for an electrophysiologist, requiring only an overnight hospital stay and a couple of follow-ups," Dr. Saliba says.

The LARIAT® suture delivery system (SentreHEART) is an FDA-approved option similar to the surgical ligation of the LAA, says Dr. Saliba.

“By using a transseptal approach and an epicardial approach, the LAA is actually caught and ligated by using a preformed knot on a catheter,” he explains. “That also is a fairly easy procedure for an electrophysiologist.”

There is not any data yet demonstrating whether the procedure reduces the risk of stroke, but Dr. Saliba says that extrapolation from the surgical literature suggests that this is probable.

The AMPLATZER™ Cardiac Plug (St. Jude Medical) is another option, similar to the Watchman, that is currently being investigated. The device was engineered to occlude the LAA at the base of the orifice, regardless of LAA anatomy.

"These devices are things that we are very excited about for the future,” Dr. Saliba says. “Down the road, it may even be possible to place one of them in conjunction with an a-fib ablation."

To refer a patient to the Cardiac Electrophysiology and Pacing Section at Cleveland Clinic, please call toll-free 800.223.2273, ext. 46697 or contact us online.

Reviewed: 04/13

Talk to a Nurse: Mon. - Fri., 8:30 a.m. - 4 p.m. (ET)

Call a Heart & Vascular Nurse locally 216.445.9288 or toll-free 866.289.6911.

Schedule an Appointment

Toll-free 800.659.7822

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

© Copyright 2014 Cleveland Clinic. All rights reserved.

HealthHub from Cleveland Clinic

Read the Latest from Our Experts About cctopics » Heart & Vascular Health
High Blood Pressure? Don’t Take Vitamin D for It (Video)
11/20/14 8:31 a.m.
Sellers of vitamin D claim the nutrient can lower your blood pressure. But don’t believe the hype. Despite claims from the nutrition industry and non-medical personnel abou...
by Steven Nissen, MD
When Your Heart Stents Narrow, Brachytherapy Can Help
11/19/14 8:22 a.m.
Cardiac stents are an effective, nonsurgical way of holding a narrowed or blocked artery open to increase blood...
A Post ER Follow-Up Could Save Your Life
11/17/14 8:39 a.m.
Even if Emergency Room doctors say you didn’t actually have a heart attack, that doesn’t mean you h...
Recipe: Low-Fat Crunchy Pumpkin Pie
11/14/14 7:00 a.m.
This low-fat crunchy pumpkin pie uses only a small amount of oil in the crust and skim milk in the filling to m...
Varicose Veins: Not Just an Older Woman’s Problem
11/13/14 8:13 a.m.
You might think of varicose veins as an older woman’s problem, but it may actually have more to do with your li...