Becky Palmer working in her yard

Your Health | 11 months ago

Prevent Strokes Without Medication or Invasive Surgery

Thanks to innovative technology, patients with atrial fibrillation who can’t take blood thinners can still prevent strokes with less anxiety and worry. Heart experts at Atrium Health Cabarrus are now offering heart implant procedures that provide long-term stroke prevention close to home.

In 2017, Becky Palmer had a minor stroke and atrial fibrillation. She was put on a blood thinner to prevent future strokes. But now, at age 71, her blood thinner wasn’t working and was making her sick.

In March 2021, Becky was admitted to the ICU. Her doctors determined that her blood thinner was causing ulcers in her digestive system to bleed. At that point, Becky was very concerned about her health issues interfering with her ability to care for herself. “I don’t want to live like that,” she said. “I’m a very independent person, and I don’t want to depend on anybody, not even my beautiful daughter.”

With the goal of finding a treatment tailored to Becky’s needs, doctors from Atrium Health Sanger Heart & Vascular Institute introduced Becky to a left atrial appendage closure (LAAC) procedure, also known as left atrial appendage occlusion (LAAO). This minimally invasive procedure is designed to help patients with nonvalvular atrial fibrillation – an irregular heart rate not caused by a heart valve problem – who can’t take blood thinners.

“Patients with atrial fibrillation are usually prescribed blood thinners for the rest of their lives to prevent strokes,” explained Terence Hill, MD, interventional cardiologist at Sanger Heart & Vascular Institute - Concord. “Since blood thinners carry an increased risk of bleeds and falls, their long-term use tends to increase worry and anxiety in patients and their families.”

Doctors at Atrium Health Cabarrus have launched LAAC implant procedures to provide community-based treatment for patients with atrial fibrillation who can’t take blood thinners. Dr. Hill and Manish Jain, MD, electrophysiologist at Sanger, share insights on this innovative technology and how it will benefit the community.

How does the implant work?

Dr. Jain: Atrial fibrillation causes the heart to pump abnormally, which can cause blood to collect in the left atrial appendage (a small pouch located in the top left chamber of the heart) and form clots. The implant helps the body form a barrier that closes off the left atrial appendage, preventing blood clots from escaping and causing a stroke.

What makes this procedure different from others?

Dr. Hill: This procedure is an FDA-approved method for reducing stroke risk in patients who can’t take blood thinners. It provides lifelong stroke protection with a one-time procedure. The device is implanted through an artery in the groin. Because it’s a minimally invasive procedure, there are no large incisions or open-heart surgery involved.

How has Sanger been involved in national research for LAAC devices?

Dr. Jain: Between 2013 and 2015, Sanger was part of PROTECT AF, the clinical trial used to bring the first LAAC device to market. We were among the few healthcare systems in the U.S. involved in this research and testing. Since the clinical trial, Atrium Health Carolinas Medical Center has been using LAAC implants to help patients with atrial fibrillation prevent strokes. We are currently involved in the OPTION and ASAP TOO trials, which further study the device.

Dr. Hill: We participate in the National Cardiovascular Data Registry LAAO Registry to help monitor the safety and effectiveness of the procedure and make continuous improvements. We were also early adopters of the latest LAAC device on the market. By using the latest LAAC technology, we can provider safer treatments to a wider range of patients.

How does the new procedure benefit patients in the Cabarrus region?

Dr. Hill: Thanks to our new heart and vascular tower at Atrium Health Cabarrus, we can offer LAAC treatment as an extension of the innovative cardiovascular and radiology services we provide to patients in Cabarrus and Rowan County. Our heart specialists partner with Carolinas Medical Center, a high-volume center with extensive experience and low complication rates, to provide the best possible care for our patients.

No other hospital in the Cabarrus region offers LAAC procedures. People really appreciate the convenience of having a procedure close to home without having to travel to Charlotte. This allows for easier family involvement, particularly for patients who do not drive themselves.

What kind of recovery can patients expect after the procedure?

Dr. Jain: Recovery time is short, with only 3 hours of bed rest required afterward. Patients stay in the hospital overnight for monitoring and return home the next day. Most patients can easily resume daily activities after the procedure.

Dr. Hill: We usually see patients for a quick checkup with one of our nurse practitioners or physician assistants about 1 week after the procedure. We perform a repeat transesophageal echocardiogram ( a special type of heart ultrasound) 6 weeks after the procedure to ensure that the device is maintaining a complete seal.

How did things work out for Becky? Her cardiac care team, led by Jonathan Schwartz, MD, performed a successful LAAC procedure. She spent the night in the hospital and returned home the next day. Within a short time after the procedure, she was taken off her blood thinner and transitioned to an antiplatelet medication and aspirin.

Throughout her experience, Becky was impressed by the personalized, attentive care she received at Sanger. “I felt like I had my own personal care team that I could contact about anything at any time,” she related. “One of my nurses even gave me her cell phone number and told me to call her if I had a problem – no matter what.”

“My care team helped me feel like I didn’t have to face this alone,” explained Becky. “My doctors and nurses really carried me through the experience so I didn’t have to worry about anything. I was able to sleep at night without worry.”

With her health issues under control, Becky’s looking forward to spending more time outdoors. “I’m very active,” she said. “I have 10 green fingers and love to work in the yard. I’m also excited about returning to the golf course with my friends.”

Learn more about Sanger’s heart rhythm care. A team of experts offers dedicated care for atrial fibrillation, combining clinical experience with expertise in the latest technology.