Dr Iqbal Malik chaired a webinar on Friday 26th May 2023 with a world-class faculty. Let’s take a look at his thoughts on stroke reduction, closing your Left Atrial Appendage (LAA) with an occluding device and an interesting new product known as the Omega device.
What is atrial fibrillation (AF)?
Atrial fibrillation is an irregular heartbeat where the top chamber of the heart does not contract properly. It can lead to symptoms of palpitations and breathlessness. It also carries a risk of stroke, as blood moves slowly through the top chamber and can stagnate and clot.
What is the Left Atrial Appendage (LAA)?
It is an “ear” or auricle that hangs off the Left atrium (top collecting chamber of the heart). If blood is moving slowly in the left atrium due to AF, it is even slower in the LAA, and this is where the clot that can cause stroke in AF can come from.
How can I avoid having a stroke if I have AF?
If you are young with no risk factors for heart trouble at all, then your stroke risk will be low. We use a risk score to assess it.
We use CHADVASC to check the risk score. If your score is 1 or more, the risk of stroke rises and blood thinners are often suggested – including warfarin and the newer blood thinners called Direct Oral Anticoagulants (DOACS).
What if I have a high bleeding risk as well?
If the bleeding risk is high (e.g. you have anaemia, gut issues, or you’ve had brain bleeds) then the blood thinners can be risky and Left Atrial Appendage Occlusion (LAAO) may be best.
What is Left atrial appendage occlusion (LAAO)?
This is a percutaneous procedure that in effect “plugs” the LAA – isolating it and avoiding clots from forming. Many different devices exist for this, and I feel there is still no “perfect” device
What is the omega device?
It’s a newer device that appears easy to place and comes in many shapes and sizes. In this webinar that I chaired, we heard from experts around the world about how to assess a patient for LAAO, and how to do LAAO safely with this device.
Do I need Left Atrial appendage Occlusion (LAAO)?
If you would like to be assessed for the procedure, I would be happy to see you. You will need a battery of investigations to
- Confirm that you do have AF
- Assess your stroke risk
- Assess your bleeding risk
- Assess your left atrial appendage size and shape – including Cardiac CT or Transoesophageal Echo (TOE)
Then I can advise you on if Left Atrial Appendage Closure is right for you.