Innovative procedure for atrial fibrillation reduces risk for stroke

The UNC Center for Heart and Vascular Care is the first in North Carolina to use an innovative procedure for people at risk for stroke.

The award-winning team of heart doctors at UNC is treating atrial fibrillation (AF) patients with the new Lariat® procedure, a minimally-invasive alternative for people who cannot tolerate blood thinners. For these AF patients - who account for 25 percent of all AF patients - it can essentially eliminate their risk for stroke, which is five times more likely in AF patients.

Not only did UNC perform the first Lariat® procedure in North Carolina, they also performed the second Lariat procedure in North Carolina on the same day. No other hospital in North Carolina offers this technology.

AF is the most common abnormal rhythm of the heart, affecting five million adults in the United States. In a person with normal heart rhythm, the heart muscle is stimulated to squeeze in rhythm by electrical impulses in the heart. Patients with atrial fibrillation suffer from a rapid and irregular heartbeat, which can cause serious complications, including stroke, heart failure and early death.

The left atrial appendage is a small sac located high in the left atrium of the heart, into which blood can accumulate and clot. In patients with atrial fibrillation, 90% of all clots arise from here, leading to a dramatically high risk of stroke.

Paul Mounsey, MD, PhD, heart rhythm cardiologist and Director of the UNC Heart Rhythm Service says, "This collaborative procedure is a new facet of the comprehensive package of cardiovascular services provided at UNC to help each patient with their individual cardiac needs."

Eugene H. Chung, MD, is a heart rhythm cardiologist who performed the procedure with Dr. Mounsey. "Through a tiny incision in the chest, we guide the Lariat to the heart. Then we essentially 'lasso' the appendage with the Lariat, which delivers as a suture to tie off the appendage, stopping blood flow."

"Once blood supply has stopped, the atrial appendage withers away," adds Dr. Mounsey.

In addition, Andy Kiser, MD, Chief, Division of Cardiothoracic Surgery, served as the cardiac surgeon and Alan Hinderliter, MD, performed the echocardiography, giving the physicians important, detailed images of the heart and confirming the efficacy of the procedure.

78-year old Santana Ortiz of Benson, NC was the first patient to undergo the Lariat procedure. Sitting up and talking the next day, Ortiz is thrilled with the outcome.

"The operation went better than I thought," says Ortiz. "I feel so much better knowing that my risk for stroke is so low, and I think my doctors did a very good job."

Just hours later, Carolyn Hicks of Clinton, NC became the second patient in North Carolina to have the Lariat procedure.

"I was scared beforehand, but I talked with Dr. Chung about the procedure, and I felt really confident that I was in good hands."

Just one day after the procedure, Hicks is feeling good and can make light of her 'newfound fame' as the second person in North Carolina to have the Lariat procedure.

"I feel famous because I feel better," Hicks laughs. "I am going home knowing that my stroke risk is practically gone. That feels great."