Atrial fibrillation, commonly called AFib, affects about 10.5 million Americans and significantly increases the risk of stroke.
The condition causes the heart to beat irregularly, allowing blood to collect in the upper chambers.
When blood pools, clots can form and travel to the brain, leading to a stroke. Doctors typically prescribe blood thinners to prevent this, but these medications are not suitable for everyone.
Blood thinners can be expensive and may increase the risk of bleeding, especially for people with active lifestyles or jobs that involve physical labor.
Some patients also stop taking them due to side effects or cost.
Because of these challenges, doctors have developed another option: a small device that seals off the part of the heart where clots often form.
This procedure involves placing a device into the left atrial appendage, a small pouch attached to the heart’s upper chamber. In people with AFib, this pouch is a common site for blood pooling and clot formation.
The device works like a plug, closing off the area so clots cannot develop there. Once implanted successfully, many patients no longer need long-term blood thinners and have a lower risk of stroke.
Cardiologist Dr. Atman Shah from the University of Chicago Medicine has been implanting these devices for more than a decade.
He explains that although the appendage’s purpose in adults is unclear, sealing it can prevent serious complications. Two devices are currently approved in the United States, and both have helped many patients who cannot safely take blood thinners.
Recent research has focused on improving how these devices are used. One study examined the medications patients take after implantation to prevent clots forming around the device itself.
Traditionally, doctors prescribe two blood-thinning drugs, but data showed that patients taking only one had fewer bleeding problems without an increase in clots. This suggests that a simpler treatment plan may be safer for some people.
Another study compared two imaging techniques used during the procedure. The older method requires a probe inserted through the throat and general anesthesia, while a newer technique uses a catheter placed through a vein to view the heart from inside.
Researchers found that both methods were equally safe and effective, though the newer approach may become more efficient as doctors gain experience.
Despite these advances, current devices do not work for everyone. Nearly one in five patients cannot receive them because the shape of the device does not match the natural shape of the heart’s appendage. This mismatch can lead to leaks or clots. The devices also rely on small hooks to stay in place, which can sometimes cause tissue injury.
To address these issues, Dr. Shah is developing a new device designed to better fit individual patients. Called Parasol, it aims to reduce trauma, improve sealing, and lower the risk of complications. The team also hopes it will be more affordable than existing options.
Experts say continued research is essential to ensure these devices remain safe and effective for diverse populations. For many people living with AFib, improved treatments could mean fewer medications, lower stroke risk, and a better quality of life in the years ahead.
Source: University of Chicago.
