Our heart has its own wiring system which conducts electrical impulses from its pacemakers to the entire heart musculature. The conduction of the electrical impulse has to be synchronous and rhythmic for effective functioning of the heart. If there is anything abnormal in the rate and rhythm of the beating of the heart, it is called' ARRHYTHMIA’.
One of the most common arrhythmia is ATRIAL FIBRILLATION (AF). AF can result in fatigue, palpitations, breathing difficulty, dizziness or sudden loss of consciousness. It is also common for AF to be completely silent and you may not be aware of its presence.
AF can result in the above mentioned symptoms which can be managed with optimal medications. But the most dangerous complication of AF is formation of blood clot inside a chamber of heart called left atrial appendage (LAA). These clots can break from LAA and travel to the brain causing immediate paralysis and other neurological damages. It can be life threatening and has the potential to disable the patient for his/her whole life.
Can we prevent it?
The answer is YES. After diagnosing AF, the cardiologist will calculate the risk of paralysis using various risk score sand; if the risk is high, you will be put on blood thinners called anticoagulants. But the problem with blood thinners is that it can cause bleeding. So if the risk of bleeding is high, proper blood thinners cannot be prescribed. In such patients, there is new hope in the form of an intervention called LEFT ATRIAL APPENDAGE CLOSURE (LAAC), where we do small intervention through a small access in the leg and block the LAA (which is the source of clot formation). The patient can be discharged the very next day.
The video here explains an alternate solution to stroke risk reduction using LAAC. (Video Courtsey - Boston Scientific Europe YouTube Video).
After few months of the procedure, we can completely stop the use of strong blood thinners in such patients, thereby achieving our goal of preventing a paralysis due to brain stroke, and at the same time reducing the risk of bleeding associated with the long term use of blood thinners. It is done in select few hospitals in India.