What Is the Lariat Procedure?
Lariat is a minimally invasive catheter-based procedure used to treat atrial fibrillation (Afib). An estimated 2.7 to 6.1 million Americans – including 9% of those over age 65 – have AFib, according to the U.S. Centers for Disease Control and Prevention. Symptoms include heart palpitations, lightheadedness, fatigue, shortness of breath and chest pain. AFib increases a person’s risk for stroke by four to five times.
In AFib, the electrical signals that regulate the heartbeat become erratic. Instead of beating regularly, the upper chambers of the heart quiver and blood doesn’t flow well, which may lead to blood clots or a stroke. In these cases, the thumb-sized pouch attached to the heart (the left atrial appendage) needs to be tied off, separating it from the rest of the heart.
The Lariat procedure uses two catheters to tighten a loop of suture material – similar to a lasso – around the base of the left atrial appendage, sealing it off from the rest of the heart so the heartbeat can return to normal.
Who Is Lariat for?
To reduce the life-threatening risk of blood clots, AFib patients typically are put on blood thinner medication. However, not all patients can tolerate blood thinners, as they increase the risk of bleeding and bruising and restrict participation in activities such as contact sports. Blood thinners can also cause stomach pain and other side effects.
The Lariat procedure eliminates a main source of blood clots (the left atrial appendage) so it is particularly beneficial to patients who cannot tolerate blood thinners.
Why Loyola?
Loyola serves as a major regional and national referral center for the treatment of complex rhythm disorders, offering treatment options (like the Lariat procedure) often unavailable elsewhere. Our skilled team of leading electrophysiologists (cardiologists who treat heart rhythm disorders), advanced practice nurses, technical staff, imaging experts and other professionals provide an integrated approach to the diagnosis and treatment of a variety of rhythm disturbances and their associated underlying conditions.
What to Expect with Lariat
Electrophysiologists at Loyola combine standard catheter ablation treatment for atrial fibrillation (AFib) along with the Lariat procedure.
During the Lariat procedure, a local anesthetic is used to numb the area under the breastbone. After the area is numbed, two catheters are guided into the patient's heart to seal the left atrial appendage with a suture loop that is similar to a lasso. Once tied off, the appendage will become harmless scar tissue over time.
Unlike traditional surgical treatments, this procedure is completed through small punctures in the skin, so in addition to less pain, the patient benefits from a shorter recovery time and less risk of complications.
Risks of Lariat
The Lariat procedure is a minimally invasive procedure and in most cases patients will be discharged the day following treatment.
Potential complications post-procedure are low and may include:
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Sharp chest pain caused by pericarditis (inflammation of the pericardium, the fibrous sac surrounding the heart)
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Bruising and soreness around where the catheter was inserted
Discuss additional risks and benefits of the procedures with your physician.
Research and Clinical Trials
Loyola is currently conducting a clinical trial called aMAZE. In this trial, one group of patients will be randomly assigned to undergo the Lariat procedure, in addition to receiving catheter ablation. They will be compared with a control group of AFfib patients who will undergo catheter ablation alone.
The aMAZE trial is open to patients with persistent AFib that has failed to respond to at least one AFib medication. For more information, call Loyola at 708-216-5609.
