Intermountain Press Release

Salt Lake City—Atrial fibrillation is the most common heart rhythm disorder in the United States affecting more than two million people who are at significantly higher risk to suffer a stroke.

Until now, people who suffer from atrial fibrillation - an irregular, disorganized electrical activity in the upper chambers of the heart that results in ineffective pumping action - have managed the disorder through blood-thinning medications. However, these medications can have side-effects and require constant monitoring.

Now, there may be new hope for patients who suffer from atrial fibrillation. Cardiologists at LDS Hospital are participating in a promising international clinical trial of an implant device that is designed to prevent strokes in patients with atrial fibrillation. LDS Hospital is one of 60 centers - the only Utah center - in the world involved in the PROTECT AF clinical trial, which is a large randomized trial studying the effectiveness of this implant technology versus blood-thinning medications, which helps reduce the risk of stroke for these patients.

Patients with atrial fibrillation are at a six-fold increased risk of stroke versus patients in normal rhythm because of this ineffective pumping action of the heart. This disorder causes blood to stagnate or pool in the left chamber of the heart placing patients at a heightened risk for a stroke.

The American Heart Association estimates that 20 percent of all strokes result from atrial fibrillation and tend to be more debilitating due to the larger size of the clots. Typically patients with atrial fibrillation take blood thinning medications to prevent these clots from forming in the heart. Current blood thinning medications require frequent monitoring and have diet and other drug interactions causing many patients to stop taking these drugs. Patients who stop the medications are at great risk to suffer a massive stroke.

Most strokes associated with atrial fibrillation are thought to be due to migration of blood clots that form in the left atrial appendage of the heart. The left atrial appendage is about the size of a thumb beyond the mid-joint and usually has an opening about the size of a dime. In a normal heart, the appendage contracts along with the rest of the atrial muscle allowing the blood to move in and out. When the atrium loses its ability to contract in atrial fibrillation, blood pools in the appendage, providing an environment for blood to clot. These clots can then break lose and migrate through the bloodstream and up to the brain causing a major stroke.

The new device being studied at LDS Hospital, called the Watchman left atrial appendage system, was developed to isolate the left atrial appendage and is designed to capture any clots that may form in the appendage potentially reducing the risk of stroke and eliminating the need for long term use of blood thinning medications. The device is inserted into the heart via a flexible catheter through a vein in the groin in a procedure performed in the cath lab.

This is the first study of its kind to determine the effectiveness of a device to isolate this appendage of the heart.

"The ability to isolate the left atrial appendage without major surgery potentially offers many clinical advantages to our patients with atrial fibrillation who are at risk of having a stroke," says Dr. Brian Whisenant, a cardiologist at the Utah Heart Clinic at LDS Hospital and principal investigator of the study at the hospital. "The evolution of this procedure and technology may greatly reduce the need for blood thinning medications and decrease the number of strokes in this high-risk patient population."

To enroll in the study or to get more information, please call the Utah Heart Clinic at LDS Hospital at 408-3900.