New Procedure Reduces Stroke Risk in Atrial Fibrillation Patients 
Friday, 14 June 2013 
ST. LOUIS – Cardiac specialists at Saint Louis University Hospital are among the first in the region to perform a new procedure reducing stroke risk for patients in atrial fibrillation (AFIB) and in turn eliminate their need for prescription blood thinners.

The procedure ties off the heart’s left atrial appendage (LAA) using a pre-tied suture loop that is threaded through the body via catheter in a procedure called an occlusion. For patients with AFIB, an occlusion is an option as blood clots arise from the left atrial appendage in more than 90% of cases. Should a blood clot dislodge and travel into the brain, ischemic risk is very high.

Traditionally, patients have been treated with anti-coagulants such as warfarin to reduce stroke risks, but such blood thinners do carry side effects.

“We are able to do this minimally invasively without opening up a patient’s chest,” says Michael Lim, MD, co-director of the Center for Comprehensive Cardiovascular Care (C4) at Saint Louis University Hospital and a SLUCare interventional cardiologist. “We want to give patients options and this allows them to have choices beyond warfarin.”

Dr. Lim and colleague Ali Mehdirad, MD, SLUCare electrophysiologist, performed their first occlusion in the Saint Louis University Hospital cardiac catheterization lab June 10 with Richard Lee, MD, C4 co-director and cardiac surgery chief in the room. The patient was a 70-year-old St. Louis woman in AFIB who was unable to take blood thinners, putting her at increased stroke risk.

Using the LARIAT® Suture Delivery Device, Drs. Lim and Mehdirad accessed the LAA by inserting a catheter under the rib cage. Another catheter is inserted through a vein in the groin up into the heart, and positioned inside the LAA. From both angles, Dr. Lim then used the loop to suture over the LAA.

“This lowers a significant stroke risk in a high-risk patient population,” says Dr. Lim. “By having an interventionalist, electrophysiologist and cardiac surgeon all in the cath lab during the case, we are able to provide a true team approach for our patients.”

AFIB is a type of arrhythmia where the electrical signals in the atria (the two upper chambers of the heart) are fired in a very fast and uncontrolled manner. The atria quiver instead of contracting normally. The electrical signals then arrive in the ventricles in an irregular fashion. When the atria do not contract effectively, the blood may pool or clot in areas such as the LAA.

For more information about atrial fibrillation, visit


About Saint Louis University Hospital

Saint Louis University Hospital is a 356-licensed bed quaternary/tertiary referral center located in the heart of the city of St. Louis. Approximately 75 percent of patients are drawn from a 150-mile radius. Through affiliation as the teaching hospital for Saint Louis University, the hospital provides patients and their families with an environment of medical innovation. Working in this endeavor are the hospital’s medical staff partners, SLUCare, the physicians of Saint Louis University. The hospital admits more than 17,000 patients annually, performs more than 200 organ transplants a year and is a Level I Trauma Center that treats more than 2,000 major trauma cases a year. For more information, please visit



Jason Merrill