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February 26, 2002

Promising New Procedure To Prevent Strokes Performed For First Time in Georgia at Emory University Hospital

People who are at risk for stroke due to the heart rhythm disturbance known as atrial fibrillation (AF) -- and who can't take blood thinners to prevent the blood clots that cause stroke -- may one day have their stroke risk virtually eliminated during a 90 minute outpatient procedure.

Emory cardiologists are participating in a multi-center study of new technology, known as PLAATO™ (Percutaneous Left Atrial Appendage Transcather Occlusion), that uses a tiny implantable device to prevent stroke by eliminating the source of blood clots that frequently cause stroke in people with AF.

Developed by Appriva Medical Inc., the PLAATO™ device is shaped like a miniature cage and covered with Gore-Tex. A small catheter threaded into the heart deposits the device into a pouch-like appendage attached to the upper chamber of the heart where blood clots are known to form in AF patients. "By permanently occluding this structure, clots that develop there are unable to break off, travel to the brain and result in stroke," explains Emory Heart Center interventional cardiologist Peter Block, M.D., who is heading the PLAATO research team at Emory.

The procedure offers new hope to people at risk of stroke from atrial fibrillation. Affecting approximately 2.2 million Americans, AF results when the upper chambers of the heart contract in a rapid and/or disorganized way. Stroke, the most serious consequence of AF, can develop as a result of blood clots that form in the erratically contracting upper chamber of the heart. AF increases the risk of stroke five fold and accounts for approximately twenty percent of all strokes.

Anticoagulants are the current standard -- and only proven -- therapy for the prevention of stroke due to AF. Unfortunately, studies have shown that up to two-thirds AF patients who are at risk of stroke can't or won't take anticoagulants, usually the blood thinner known as warfarin.

"Chronic warfarin therapy is known to reduce the risk of thromboembolic events among those with AF and clinical risk factors but it is one of the most difficult medications to administer in clinical practice," says Dr. Block, who recently performed the first PLAATO™ procedures in Georgia and among the first in the nation. He points out that frequent blood testing is required and, in addition, warfarin is difficult to manage because of the large number of drugs and foods that interact with the anticoagulant. Patients also have up to a two percent risk a year for life threatening hemorrhages.

"The PLAATO™ procedure represents a promising therapeutic alternative to a failed regimen of medication and frequent blood monitoring. It has the potential to prevent thromboembolic stroke in this high-risk population with a single catheter intervention," says Dr. Block. "If the trials are successful, the device could be an important interventional cardiology procedure."

Since 1975 Emory Crawford Long Carlyle Fraser Heart Center has been recognized internationally for its work in the diagnosis treatment and prevention of heart and lung disease. The Carlyle Fraser Heart Center is part of the Emory Heart Center, ranked in the top ten America's Best Hospitals by US News & World Report. Emory Hospitals include Emory University Hospital, a 587-bed hospital located on the Emory University campus in northeast Atlanta, Crawford Long Hospital, Emory's 583-bed, community-based hospital in midtown and Wesley Woods Geriatric Hospital, a100-bed hospital located on the Emory campus. Emory Hospitals are components of EMORY HEALTHCARE, the most comprehensive health care system in Atlanta. Other components of EMORY HEALTHCARE are: The Emory Clinic, the Emory Children's Center, the jointly owned Emory-Adventist Hospital, and EHCA, LLC, a limited liability company created in collaboration with HCA Healthcare.

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