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Heart Health

Stroke prevention in atrial fibrillation: Beyond anti-clotting drugs

October 1, 2021

Procedures that block or remove the source of dangerous blood clots in the heart may be an option for growing numbers of people.

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More than five million Americans have atrial fibrillation, a heart rhythm disorder commonly known as afib. During a bout of afib, the heart’s upper chambers (atria) suddenly start to quiver ineffectually. When that happens, blood tends to pool — and possibly form clots — in a small pouch that protrudes from the top of the left atrium. This ear-shaped sac is called the left atrial appendage (LAA).

About 90% of blood clots in the heart form in the LAA. These clots can escape the heart and travel to the brain, blocking blood flow and causing an ischemic stroke. Most people with afib take anti-clotting medications that help prevent these strokes. However, some people develop serious bleeding problems while taking those medications. Also known as blood thinners, these drugs are especially risky for older people who are vulnerable to head injuries from falls, increasing the risk of bleeding in and around the brain.

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