Device Therapy for Atrial Fibrillation & Atrial Flutter in Adults
NYU Langone cardiac electrophysiologists manage atrial fibrillation and atrial flutter by preventing stroke, restoring a normal heart rate rhythm, and ensuring an appropriate heart rate. This may involve the use of medication or implantable devices, such as cardiac loop recorders, pacemakers, and defibrillator therapy, as needed.
Your doctor may recommend other cardiac devices to reduce the risk of developing blood clots or to manage symptoms of heart failure. Specialists at the Heart Failure Advanced Care Center collaborate with our experts at the Heart Rhythm Center to manage this condition.
Left Atrial Appendage Occlusion Device
Atrial fibrillation can increase your risk for blood clots, which can cause a life threatening stroke. Your cardiac electrophysiologist may recommend a left atrial appendage occlusion device if you have atrial fibrillation but can’t tolerate the side effects—such as excessive bleeding—of anticoagulants, which prevent blood clots.
This device closes off the left atrial appendage, a small sac located in the muscle in the heart’s left atrium. Blood can collect here in people who have atrial fibrillation. This blood can clot and travel to the brain, causing a stroke.
In this procedure, which is performed with general anesthesia, your doctor uses a transesophageal echocardiogram to guide two catheters, which are hollow tubes, to the heart. First, your doctor places the catheters inside sheaths and leads them through the femoral vein in the leg and into the atria. Next, he or she seals off the left atrial appendage with the atrial occlusion device, which is delivered through the catheter. This helps prevent blood from pooling in the sac.
The procedure takes two to four hours and typically requires an overnight stay in the hospital. After the procedure, you must lie flat for up to four hours, but you are able to eat or drink during this time.
Heart Failure Monitor
If atrial fibrillation or atrial flutter has led to heart failure, in which the organ doesn’t pump enough blood to the body, your NYU Langone cardiac electrophysiologist may implant a wireless pulmonary artery sensor, or heart failure monitor.
This sensor measures the pressures in the pulmonary artery, the vein that carries blood from the heart to the lungs. Changes in these pressures can indicate that heart failure is worsening.
The sensor wirelessly transmits data to the CardioMEMSTM system, which allows your cardiologist to track your heart’s functioning and provide additional treatment as needed.
To implant the device, your cardiac specialist inserts a catheter into the femoral vein in the leg and advances it to the pulmonary artery. Next, he or she threads a guide wire through the catheter to insert and implant a small sensor in the pulmonary artery.
The implanted sensor measures pressures in the pulmonary artery. This information is wirelessly transmitted to your doctor via a secure internet site, allowing him or her to detect any changes in your condition that may require treatment.