September 02, 2020
Jacksonville, FL - Cardiologist Amit Gupta, MD with Baker-Gilmore Cardiovascular Institute and Electrophysiologist Morhaf Ibrahim, MD with Ibrahim Heart Clinic became Jacksonville's first physicians to implant a next generation device to reduce the risk of stroke for patients with Atrial Fibrillation (Afib). Both performed the procedure, a Left Atrial Appendage Closure (LAAC), at Memorial Hospital first on an 84 year-old male and next on a 69 year-old male, both of whom are doing well and recovering at home.
Afib is one of the most common forms of heart disease and affects more than 2.7 million people in the United States. "Many patients describe Afib as feeling like a quivering heart beat, "explained Dr. Gupta. "Patients with Afib are five times more likely to suffer a stroke than someone with a regular heartbeat. Understanding the connection between Afib and stroke helps patients learn how the LAAC works."
Afib affects the heart's ability to pump blood normally. This can cause blood to pool in an area of the heart called the Left Atrial Appendage, or LAA. There, blood cells can stick together and form a clot. When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.
"For patients with Afib not caused by a heart valve issue, more than 90% of stroke-causing clots that come from the heart are formed in the LAA. Closing off this part of the heart has been a proven alternative to reduce stroke risk," explained Dr. Ibrahim. Like most blood thinning medications, the LAAC device can effectively reduce stroke risk and eliminate the need for blood thinners. This permanent implant is for people with Afib not caused by a heart valve problem who need an alternative blood thinner. The LAAC device is about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.
"The device is implanted into the heart in a one-time procedure. It's a permanent device that doesn't have to be replaced and can't be seen outside the body," said Dr. Ibrahim.
To implant the device the physician makes a small cut in the upper leg and inserts a narrow tube, as done in a standard stent procedure. The doctor then guides the device into the left atrial appendage (LAA) of the heart.
Dr. Gupta explained, "The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day,"
In a clinical trial 92% of patients were able to stop taking blood thinners 45 days after the procedure and 99% of patients were able to stop taking warfarin within one year after the procedure.