ABOUT 'BEAT YOUR A-FIB'...


"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su Cavanaugh Heart Center, Phoenix, AZ

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"



ABOUT A-FIB.COM...


"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013


 FAQs Understanding A-Fib: LAA

FAQs Understanding Your A-Fib A-Fib.com9. “My surgeon wants to close off my LAA during my Mini-Maze surgery. Should I agree? What’s the role of the Left Atrial Appendage?”

The Left Atrial Appendage (LAA) is a pocket or sleeve-like structure on the outside left top of the left atrium which opens into the left atrium. It’s a complicated structure with often more than one lobe. From an embryonic perspective, the LAA is more related to the ventricles than to the smooth-walled atrium.

In the first trimester or two of our time in the womb, The Left Atrial Appendage (LAA) was originally our left atrium (LA). When the final real Left Atrium (LA) formed gradually from the conjunction and evolutionary development of the four pulmonary veins, the actual LA chamber grew and ballooned out, pushing the smaller remnant LA up to the left top of the Left Atrium where it became known as the Left Atrial Appendage (LAA) with its own functions and behaviors. But as we age and as heart disease/A-Fib, etc. start to set in, the LAA can turn into “the most lethal, no longer essential appendage in the human anatomy.” (Thanks to Shannon Dickson for these insights about the LAA.)

Sometimes during a difficult A-Fib catheter ablation case (persistent or long-standing persistent), the LAA has to be partially or completely electrically isolated from the rest of the heart. When the LAA is ablated, there is a 70% chance of significantly reducing its emptying volume. If the LAA emptying volume is reduced to less than 40 millileters/sec, the patient would have to be put on blood thinners for life or their LAA would have to be removed or closed off. Otherwise clots would form in the LAA because of low blood flow.

Left Atrial Appendage; Source: Boston Scientific Inc. educational brochureFunctions of the Left Atrial Appendage

  1. The Left Atrial Appendage functions like a reservoir or decompression chamber or a surge tank on a hot water heater to prevent surges of blood in the left atrium when the mitral valve is closed. Without it there is increased pressure on the pulmonary veins and left atrium which might possibly lead to heart problems later.
  2. Cutting out or stapling shut the LAA reduces the amount of blood pumped by the heart and may result in exercise intolerance for people with an active life style. (In dogs the LAA provides 17.2% volume of blood pumped.)
  3. The LAA also has a high concentration of Atrial Natriuretic Factor (ANF) granules which help to reduce blood pressure. The LAA functions as a storage device for ANF. But recent preliminary research indicates that the Right Atrial Appendage compensates for the loss of the LAA by producing more ANF.
  4. The Left Atrial Appendage may also function as a reservoir of different types of stem cells which can stimulate the heart to repair itself (See
    Left Atrial Appendage May be Important for Heart Repair http://a-fib.com/laa-important-for-heart-health-repair/

The LAA, Blood Clots and Stroke Risk: In A-Fib, blood stagnates in the LAA and clots tend to form. By closing off the Left Atrial Appendage, most but not all risk of stroke is eliminated even if you are still in A-Fib.

On the other hand, cutting out or stapling shut the LAA also reduces the amount of blood pumped by the heart and may result in exercise intolerance for people with an active life style.

One considered advantage of the Mini-Maze operations is that the Left Atrial Appendage (LAA) is routinely closed off.

The Controversy: Some question the need or benefit of removing the Left Atrial Appendage (LAA) if someone is no longer in A-Fib. For a patient made A-Fib free, would their heart function better or more normally if they still had their LAA?

Editor’s comment: If you are thinking of having a Cox Maze or Mini-Maze, discuss removing the LAA with the surgeon. Ask if they close off the Left Atrial Appendage and with what: sutures, stapler or the AtriClip, and their success rate of complete closure.

Go back to FAQ Understanding A-Fib

Related Posts

Follow Us
facebook block 65 pix REVtwitter block 65 pixlinkedin block 65 pixpinterest.block 65 pix


A-Fib.com is a
501(c)(3) Nonprofit



Your support is needed. Every donation helps, even just $1.00.


We Need You
A-Fib.com Mission Statement
BYA - Alerts ad Green

A-Fib.com top rated by Healthline.com for the third year.
A-Fib.com top rated by Healthline.com for the third year. 2014  2015  2016

Mug - Seek your cure - Beat Your A-Fib 200 pix wide at 300 resEncourage others
with A-Fib
click to order

Home | The A-Fib Coach | Help Support A-Fib.com | A-Fib News Archive | Tell Us What You think | Media Room | GuideStar Seal | HON certification | Disclosures | Terms of Use | Privacy Policy