Scripps Physicians First in San Diego to Use ‘Lariat’ for Lassoing Piece of the Heart

Physicians from Scripps Health are the first in San Diego to perform an innovative nonsurgical procedure using sutures to tie off a piece of the heart called the left atrial appendage (LAA). The LAA – about the size of a jalapeno pepper – is the primary source of blood clots leading to stroke in patients with atrial fibrillation (AF), a serious heart rhythm disorder that affects millions of Americans.

The FDA-approved Lariat® Suture Delivery Device may provide effective long-term protection against stroke in patients with AF who are unable to tolerate blood thinners, according to Dr. Douglas Gibson, Scripps Clinic electrophysiologist.

“In patients with atrial fibrillation, the left atrial appendage becomes a place for blood to pool and stagnate,” Dr. Gibson said. “This appendage ultimately becomes a major source of blood clots that can cause stroke in patients with atrial fibrillation.”

With the patient under general anesthesia, Dr. Gibson and Dr. Matthew Price guide two catheters into the patient’s heart to seal the LAA with a pre-tied suture loop that looks similar to a lasso. Once in place, the physicians pull back on the Lariat device to tighten the knot and occlude the appendage. Starved of blood, the appendage shrivels into scar tissue.

“The Lariat is a very attractive alternative to a lifetime of blood thinners that can have serious side effects, such as excessive bleeding,” Dr. Price said. “This device is a viable option for those who cannot tolerate blood thinners.”

Individuals who take blood thinners, such as Coumadin, must rigorously manage the level of the drugs in their blood. For some, this management regime can mean monthly tests over the course of many years. Also, Coumadin and other anticoagulants such as Pradaxa and Xarelto can lead to significant bleeding problems in some people. By eliminating the need to take these long-term medications, the LAA procedure can reduce the need for frequent medical visits and this risk of bleeding, according to Dr. Price.

About Atrial Fibrillation

Atrial fibrillation is the most common and one of the most undertreated heart rhythm disorders in America. Approximately 3 million Americans are estimated to have the disease, and about 40 percent do not exhibit symptoms and may be under-diagnosed.

Half of all diagnosed atrial fibrillation patients fail drug therapy. If left untreated, patients have up to a five times higher risk of stroke and an increased chance of developing heart failure. Additionally, since atrial fibrillation is often age-related, as the U.S. population continues to grow older, the need for more effective treatment options is escalating.

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