Doctors & patients are saying about 'A-Fib.com'...

"A-Fib.com is a great web site for patients, that is unequaled by anything else out there."

Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN

"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."

Jill and Steve Douglas, East Troy, WI

“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP.

Faye Spencer, Boise, ID, April 2017

“I think your site has helped a lot of patients.”

Dr. Hugh G. Calkins, MD Johns Hopkins,
Baltimore, MD

Doctors & patients are saying about 'Beat Your A-Fib'...

"If I had [your book] 10 years ago, it would have saved me 8 years of hell.”

Roy Salmon, Patient, A-Fib Free,
Adelaide, Australia

"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

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient,
Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA

Lariat II Suture Delivery Device

by Steve S. Ryan, updated Oct. 2016

Lariat II, SentreHeart, Inc.

To address the increased risk of stroke, A-Fib patients are often put on anticoagulant drug therapy, such as warfarin. Because the Left Atrial Appendage (LAA) is the source of over 90% of A-Fib-related strokes, the Lariat II Suture, an occlusion device, can be used to close off the LAA, replacing the need for anticoagulants.

It is often used in cases where the patient cannot tolerate anticoagulants like Coumadin. (The Watchman device, another occlusion device, requires a patient be on anticoagulants for several months. See The Watchman™: Alternative to Blood Thinners.)

Placement of the Lariat Device

From the inside of the heart a balloon is placed inside the Left Atrial Appendage to expand it and make it accessible to the noose device which is inserted from the outside of the heart. The positioning balloon is withdrawn before the Lariat noose is closed around the base of the Left Atrial Appendage.

The noose completely closes off the Left Atrial Appendage which dies and is no longer electrically active. The Lariat II snare device has been approved by the FDA (Lariat II, SentreHeart, Inc., Palo Alto, CA).
(Added 4/13/19:) The Lariat II is currently in a second (extended) phase of an FDA clinical trial called “Amaze”. It’s due to be completed in December 2019.

Video frame: Lariat being placed

A noose device to close off the Left Atrial Appendage is inserted from outside the heart, unlike for example the Watchman device which is inserted into the LAA from inside the heart.

The Lariat device was invented by Dr. William E. “Billy” Cohn, Director of Minimally Invasive Surgical Technology at the Texas Heart Institute at St. Luke’s Episcopal Hospital.

VIDEO: Closure of the Left Atrial Appendage Technique 2: The Lariat Procedure. Using doctor interviews and animated footage, explains the need for and use of the Lariat occlusion device.

For more about the Lariat, see Alert: Patients with Lariat Device for Left Atrial Appendage Closure.

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