Introduction

What Is Atrial Fibrillation?

Atrial fibrillation (AF) is the most common type of heart rhythm disorder. In Hong Kong, it is estimated that over 70,000 people are affected by AF. When the heart beats normally, its muscular walls contract in a coordinated way to pump blood efficiently around the body. However, in AF, the heartbeat becomes fast and irregular. This prevents the heart from pumping blood properly, causing it to collect in the upper chamber (left atrium). Blood stagnation increases the risk of clot formation.

If a blood clot travels to the brain and blocks a blood vessel, it can cause an ischemic stroke. About 90% of the clots that lead to stroke in AF patients originate from a small sac-like structure in the left atrium called the left atrial appendage (LAA).

Stroke prevention is the most critical aspect of AF management.

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Causes

Causes

Atrial fibrillation (AF) is the primary cause of blood clot formation in the left atrial appendage (LAA). AF leads to irregular heartbeats, resulting in stagnant blood flow in the LAA and an increased risk of clot formation. The following risk factors are known to increase the likelihood of developing AF and LAA thrombus:

  • ● Older age (especially over 65 years)
  • ● High blood pressure (hypertension)
  • ● Diabetes mellitus
  • ● Valvular heart disease
  • ● Heart failure
  • ● History of stroke or transient ischemic attack (TIA)
  • ● Smoking and excessive alcohol consumption
  • ● Obesity or physical inactivity
  • ● Chronic kidney disease
  • ● Hyperthyroidism
  • ● Obstructive sleep apnea

These factors not only contribute to the onset of atrial fibrillation but also accelerate clot formation in the LAA, significantly increasing the risk of stroke.

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Symptoms

Symptoms

Some individuals with AF may experience:

  • ● Palpitations or irregular heartbeat
  • ● Fatigue or reduced exercise tolerance
  • ● Shortness of breath
  • ● Dizziness or light-headedness
  • ● Chest discomfort

However, others may have no noticeable symptoms.

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Operation

The LAAO Procedure

LAAO is a minimally invasive procedure performed in the cardiac catheterization laboratory under general or monitored anesthesia. With the aid of transesophageal echocardiography (TEE) and fluoroscopy (X-ray), a cardiologist inserts a catheter through the femoral vein in the patient’s inner thigh.

Through atrial septal puncture, the occluder device is delivered to the opening of the left atrial appendage. The occluder, shaped like a parachute, is deployed to seal off the LAA. Once in place, it becomes anchored to the heart tissue, forming a natural barrier to prevent clot formation.

Most patients can get out of bed on the same day after the procedure. Hospital stay is typically around 2 to 3 days.

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Notice

Postoperative Care

  • ● Please continue taking anticoagulant or antiplatelet medications as instructed by your doctor.
  • ● Avoid swimming within one week after discharge.
  • ● Take showers instead of baths, and keep the wound clean and dry.
  • ● Avoid heavy lifting and strenuous activities during the first week.

For further information, please consult your attending doctor or cardiologist. 

The above information is for reference only. As each patient’s condition may vary, please consult your doctor for individual assessment and advice.

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