Left Atrial Appendage Closure

In patients with atrial fibrillation, abnormal and chaotic electrical signals or pathways occur in the atria (the top parts of the heart), causing an irregular heartbeat and keeping the atria from contracting or squeezing normally. The atria quiver instead, lowering the amount of blood ejected from the heart with each heartbeat.

For years, Northwestern Medicine’s Center for Heart Rhythm Disorders 
at the Bluhm Cardiovascular Institute has provided a variety of ways to treat atrial fibrillation, including medication, catheter ablation and surgery. Today, the Program for Left Atrial Appendage Closure at the Center for Heart Rhythm Disorders offers two new minimally invasive procedures that may reduce a patient’s need for ongoing medical treatment with blood thinners.

What is the left atrial appendage?

The heart has four chambers, two on top and two on the bottom. The left atrium is the upper left chamber of the heart. The left atrial appendage is a pocket-like section in the left atrium of the heart. 

The left atrial appendage is not a highly necessary part of the heart. In fact, it is often a source of blood clot formation and may cause up to 90 percent of strokes due to atrial fibrillation. Closing the left atrial appendage can prevent blood clots from escaping and causing a stroke.

Bradley P. Knight, MD
, director of Cardiac Electrophysiology at Northwestern Medicine, is specially trained in two techniques used for closure of the left atrial appendage. He and his team of board-certified cardiac electrophysiologists, including Albert C. Lin, MD, work closely with a patient’s referring physician to determine the best course of treatment.

The WATCHMAN® procedure
In the WATCHMAN® procedure
, a small device is inserted into the left atrial appendage to act as a plug, cutting off blood flow and reducing risk of blood clots and stroke. While patients are required to use blood thinners for at least 45 days after the procedure, they often can stop taking medication later. 

The WATCHMAN® procedure has been found just as effective as anticoagulants for stroke prevention.

Northwestern Memorial Hospital was the first hospital in Illinois to successfully place the WATCHMAN® Left Atrial Appendage Closure (LAAC) device in a patient after the recent approval of the device by the Food and Drug Administration (FDA).

Click here
 for more information on WATCHMAN®.

The LARIAT™ procedure 
In the LARIAT™ procedure
, the opening to the left atrial appendage is sutured shut from the outside of the heart. Blood can no longer pool in the left atrial appendage, potentially reducing risk of blood clots and stroke. The LARIAT™ procedure is recommended for patients with a high risk of stroke who can’t take blood thinners. Patients who have had open-heart surgery are not candidates. 

Northwestern Memorial Hospital was the first hospital in the Chicago area to offer this groundbreaking treatment.

Benefits of treatment
Both the WATCHMAN® and LARIAT™ procedures are minimally invasive, and most patients can return home the next day. The goal of these procedures is to offer patients a reduction in chance of stroke and, for many, the chance to stop taking blood thinners altogether.

Who qualifies for treatment?
Men and women with atrial fibrillation with risk factors for stroke who are having trouble managing their anticoagulation medication, have experienced bleeding while on blood thinners, or who can’t take blood thinners at all may be candidates for treatment.

Locations Performing this Treatment