Genesis heart team performs first LARIAT procedure in IA - Genesis Health System

Published on December 06, 2013

Genesis heart team performs first LARIAT procedure in IA

Ophelia Brooks had a difficult decision to make about treating her atrial fibrillation.

Ophelia Brooks of Davenport had a first-in-Iowa procedure
at Genesis Medical Center, Davenport to correct her
atrial fibrillation.

She could have a heart surgery to correct the very common condition. But such a surgery would require a longer recovery, and she would have a surgical incision.

Or, she could choose to become the first patient in Iowa to receive the LARIAT procedure, a non-surgical, proactive treatment for atrial fibrillation. Blood thinners were not an option for the 78-year-old because of past problems using them.

“I was a little reluctant at first to be the first one,’’ Brooks said of the LARIAT procedure. “I really had to weigh my options. I had some fear but after everything was explained to me, I threw the fear away and decided to have this new procedure.’’

Brooks is one of about 3 million Americans who have been diagnosed with atrial fibrillation, a potentially serious condition putting patients at increased risk for stroke. Standard treatment options include blood-thinning drugs, radiofrequency ablation, or surgical intervention.

All options can be effective. However, a small percentage of atrial fibrillation patients, including Brooks, have an additional complication; they cannot safely use blood thinners like Coumadin (Warfarin) or the new generation of blood thinners.

“The best option then for those patients was a major surgical procedure to correct the atrial fibrillation,’’ explained Nicolas Shammas, M.D., cardiologist with the Genesis Heart Institute. “Now we have a much better option we’ve been waiting for.’’

Groundbreaking treatments at Genesis

The LARIAT procedure Brooks received is now available from the heart team at Genesis Medical Center, Davenport.

“This is a very important advancement for those patients with atrial fibrillation who cannot be on blood thinners because of past history of hemorrhaging,’’ Dr. Shammas said. “Instead of correcting the problem with a major surgery and lengthy recovery, we can correct the problem and lower the patient’s stroke risk with a much less invasive procedure and much shorter recovery.’’

Brooks was considered to be a good candidate for the procedure. The surgery went well, and she was discharged home in a few days without a surgical incision. “I thought I would have some pain but I really didn’t have any pain at all,’’ she said. “Everything is going well.’’

Atrial fibrillation patients are evaluated for treatment by a measurement called the CHADS score. CHADS is an acronym used to determine the risk of developing a stroke based on congestive heart failure, high blood pressure, age of 75 years or higher, diabetes and history of stroke.

“She did very well and was home after a few days of hospitalization,’’ Dr. Shammas added. “A major heart surgery would have been much more difficult for her to recover from.’’

Atrial fibrillation is a fast, irregular heartbeat. It develops when electrical signals telling the heart how to contract smoothly do not fire in an organized pattern.

“Instead it is a chaotic discharge, and the heart doesn’t beat correctly and the chambers don’t work in sync,’’ Dr. Shammas said. “The chaotic discharge and the atrial fibrillation create turbulence to the blood flow and allow clots to form in the left atrial appendage, where more than 90 percent of the clots that become strokes come from in these patients.’’

The LARIAT procedure uses two catheters with one of them carrying the LARIAT Suture Delivery Device. The LARIAT device literally is a loop or lasso that is placed and tightened around the base of the left atrial appendage. The loop is tightened, sealing off the left atrial appendage. The procedure blocks stroke-causing blood clots from moving and putting the patient at a higher risk for stroke.

“It was very exciting to be the first heart center in Iowa to provide this procedure,’’ Dr. Shammas said. “It takes a strong team and requires a team approach. Prakash Bontu, M.D., and Jon Robken, M.D., were also part of the team, along with the anesthesiologist Stephen DeLessio, M.D. The Genesis heart surgery team was standing by just in case there were significant issues that would require us to move to a surgical approach, but that wasn’t necessary.

“Not everyone can do this procedure, or is approved to do the procedure, because they either haven’t been trained or don’t have the skilled heart team we have at Genesis.’’

The Genesis heart team is often an early adopter of new approaches to heart care and its culture of innovation within the Genesis heart team benefits patients. For more information, call (563) 421-3900.

Symptoms of Atrial Fibrillation

The most common symptom: a quivering or fluttering heartbeat

Atrial fibrillation is the most common type of irregular heartbeat. The abnormal firing of electrical impulses causes the atria (the top chambers in the heart) to quiver (or fibrillate.)

Sometimes people with atrial fibrillation have no symptoms and their condition is only detectable upon physical examination. Still, others may experience one or more of the following symptoms:

  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure (Chest pain or pressure is a medical emergency. You may be having a heart attack. Call 9-1-1 immediately.)

Source: American Heart Association

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