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Afib? Give Up Blood Thinners for Good

By Himanshu Agarwal, MD May 24, 2024 Posted in: Heart Health

What do you do when the treatment for a serious condition is a major hassle? Or simply too expensive? It’s a common dilemma for people with atrial fibrillation (Afib). 

One in 20 people over age 65 have Afib, a rhythm disorder that causes the heart to beat irregularly. It’s the most common type of heart arrhythmia and also a serious condition because it can cause blood to pool in the heart and form clots. These clots can travel to the brain and cause a stroke. 

Blood Thinners

Blood-thinning medications are the long-standing treatment for Afib because they help prevent the formation of clots or break up existing clots which can cause a stroke. Unfortunately, these medications also increase your risk for bleeding.

Coumadin is the medication often prescribed because it is effective and affordable, but it can be difficult to regulate the dose. Newer options like Eliquis are also effective, but the retail cost can be a financial burden for patients. These medications can have other drawbacks, including:

  • Regular blood tests (once a month for coumadin) are needed to ensure it is working properly.
  • Certain foods (green, leafy vegetables) and medications (aspirin, other blood thinners) must be avoided.
  • Activities that can cause injury and bleeding must be avoided. 
  • Side effects such as nausea, stomach upset and hair loss can occur.

These medications can be particularly risky for older adults who are unsteady on their feet, as a fall can cause significant internal bleeding. The same goes for farmers or anyone who does physical work which can lead to minor injuries. 

Surgical Solution 

A simple surgery makes it possible for people with Afib to give up blood thinners for good. Implanting a tiny device called a Left Atrial Appendage Occluder, or LAAO, can provide a permanent solution to reducing stroke risk in these patients.

The quarter-sized LAAO implant works by closing off the heart’s left atrial appendage – the pouch-like area in the heart where clots can form. This pouch area is unneeded and patients experience no difference in heart function after it is closed off.

Implanting an LAAO is a one-time outpatient procedure that takes less than an hour from start to finish and most patients go home the same day within 3 to 4 hours. Despite its effectiveness, misconceptions can prevent people from taking advantage of this treatment option. Consider these facts about the LAAO: 

  • The procedure is not new. More than 1,000 of these procedures have been done here at CHI Health Creighton University Medical Center - Bergan Mercy alone. 
  • The device is not new. There’s a couple of different LAAO devices which are FDA approved and have been in use for some time. 
  • The procedure is effective. Our success rate is 99%, meaning 99% of patients are able to stop blood thinners within 45 days of the procedure. 
  • The procedure is widely covered by insurance and Medicare. If a patient’s insurance or Medicare does not cover the procedure, an ongoing clinical trial may be an option.

If you’re interested in giving up blood thinners for good, talk to your provider about whether you might be a candidate for an LAAO implant.

Himanshu Agarwal, MD
Himanshu Agarwal, MD

Dr. Himanshu Agarwal is an Interventional Cardiologist and currently serves as Director of the Structural Heart Program at CHI Health Heart and Vascular Institute in Omaha, Nebraska.

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