Texas Cardiac Arrhythmia Institute at St. David’s Medical Center First in Central Texas to Perform Procedure Using SentreHEART LARIAT Suture Delivery Device

Catheter-Based Procedure is Designed to Permanently Close the Left Atrial Appendage to Treat Patients with Atrial Fibrillation Recently, physicians at the Texas Cardiac Arrhythmia Institute (TCAI) at St. David’s Medical Center became the first in Central Texas to perform a new minimally invasive catheter-based procedure that uses the LARIAT Suture Delivery Device to close the left atrial appendage (LAA) to treat patients with atrial fibrillation (A Fib). A Fib is a type of heart rhythm disorder that affects the electrical system of the heart muscle. “This procedure is designed to permanently close the LAA without surgery, which may eliminate the need for blood thinners in some A Fib patients,” Andrea Natale, M.D., F.H.R.S., F.A.C.C., F.E.S.C., cardiac electrophysiologist and executive medical director of TCAI, said. “This is an extreme benefit to patients, as blood-thinning medications can have less-than-desirable side effects.” The LAA is a structure in the heart that excretes hormones and normally contracts slightly, which helps move blood flow in and out of the LAA. In patients with A Fib, the LAA stops rhythmically contracting, and the sluggish blood flow inside can pool and form blood clots, which can lead to a stroke—requiring many patients to take blood thinner medications as a precaution. This procedure is ideal for patients who can no longer tolerate such medications. The LARIAT Suture Delivery Device, manufactured by SentreHEART, Inc., consists of a long, soft plastic catheter tube with a tiny magnet and a lasso-shaped suture at the end. The LARIAT implant procedure involves small puncture sites rather than a large incision. After cleansing an area of skin below the breast bone with antiseptic, a local anesthetic “numbing medicine” is injected into the area, then a small needle puncture is made. The needle is directed under the breast bone, toward the left side of the heart. Using X-ray and ultrasound guidance, the needle is passed into the pericardium, which is the thick sac that surrounds the heart. Through the hollow tube inside the needle, a tiny guiding wire is passed into the sac surrounding the heart. Over this wire, a pencil-sized tube is guided toward the LAA to establish a pathway for the LARIAT catheter. The physician then passes the LARIAT device through this tube to the LAA. Meanwhile, numbing medicine is injected in the groin and tubes are inserted into those blood vessels. A soft plastic catheter is passed through the blood vessel in the leg and into the top/upper chamber of the heart, known as the right atrium. A tiny puncture is made in the wall that separates the right atrium and the left atrium. A guide wire with a tiny magnetic tip and a balloon are passed up to the heart through this catheter, across the heart wall, using X-ray and ultrasound guidance, and into the left atrium and the LAA. The magnetic wire tip within the LAA attracts the magnet wire tip in the lasso device that is on the outside of the heart, allowing the LARIAT suture loop to be advanced over the LAA. The LARIAT suture knot is then tightened around the base of the appendage to close the LAA. Once tied off, the appendage will over time shrivel into scar tissue. The first cases in Central Texas were performed at TCAI by Dr. Natale; Rodney P. Horton, M.D., electrophysiologist at TCAI; and J. David Burkhardt, M.D., electrophysiologist at TCAI. Texas Cardiac Arrhythmia Institute at St. David’s Medical Center TCAI is one of the world’s preeminent centers dedicated to the latest treatment advances for correcting abnormal heart rhythms such as Atrial Fibrillation (A Fib). The center is led by Executive Medical Director Andrea Natale, M.D., a world-renowned expert in the field. Natale is at the forefront of advancing treatment for A Fib, leading numerous clinical trials and participating in the development of new technologies and procedures. For more information, please visit TCAInstitute.com.