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AtriClip May Free Afib Patients from Blood Thinners While Reducing the Risk of Stroke
HEART
AtriClip may free Afib patients from blood thinners while reducing the risk of stroke
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Every 40 seconds in the United States someone has a stroke, and every four minutes someone dies from one, according to the Centers for Disease Control and Prevention. However, up to half of all strokes are preventable with healthy lifestyle choices such as maintaining a healthy weight and blood pressure, and not smoking.
People with atrial fibrillation (an irregular heartbeat, commonly called AFib) are five to seven times more likely to have a stroke than the general population because AFib can cause blood clots, which can be released and block blood flow to the brain. Anticoagulation therapy (blood-thinning medication) is often used to help prevent that, but some people cannot stay on blood-thinners for a long time because of a high risk of bleeding. Some people simply don’t want to take blood-thinners because of side effects.
A safe and effective alternative to medication
There is another option. A device called an AtriClip, which was developed and used as an adjunct procedure for patients undergoing open heart surgery, is now being used as a standalone procedure for patients with AFib who want to lower their risk for stroke without taking blood-thinning medication.
This new application for the AtriClip has evolved over the past 10 years, says Philip Bongiorno, MD, a Cleveland Clinic Florida cardiothoracic surgeon. It was FDA-approved for left atrial appendage exclusion during open heart surgery in 2010.
How AtriClip works to prevent strokes
The majority of blood clots caused by AFib form in the left atrial appendage (LAA) of the heart. When a blood clot is released, it can block blood flow to the brain, causing a stroke. The AtriClip is implanted into the LAA to cut off blood flow both in and out of it, thereby eliminating the risk of clot formation. After the AtriClip is implanted, AFib patients have a greatly reduced risk for stroke while being able to immediately stop taking bloodthinning medication.
The procedure itself is minimally invasive, requiring only three small incisions in the chest and a one-night stay in the hospital, Dr. Bongiorno says. In August 2020, he and his team began using a robotic approach to the procedure, which allows for even more surgical precision. Patients typically recover within about a week and can then return to normal activities.
Who is a candidate for AtriClip?
Anyone with AFib who has the desire or a medical need to stop taking blood-thinning medication is a good candidate for AtriClip. Talking to your cardiologist is a good first step to find out if you qualify for the procedure.
TALK WITH AN EXPERT.
To make an appointment with Dr. Bongiorno or another Cleveland Clinic cardiovascular medicine specialist, please call 877.463.2010 or schedule online at ClevelandClinicFlorida.org/Heart.
Probate 101
By Bruce Iden, Esquire
Probate is a lawsuit I file against myself after I die, at my own expense, for the benefit of my creditors and my heirs.
When a loved one passes away, his or her estate goes through a court-managed process called probate administration whereby their Will is evaluated by the court to determine if it was validly drawn and executed. Assets of the deceased are then collected, debts and taxes are paid and what remains is distributed to beneficiaries. Without probate administration, bank and investment accounts of the decedent are frozen. Furthermore, any real estate owned by the decedent may not be sold until authorized by the court. Probate administration involves the following steps:
• Collecting and securing estate assets • Locating the original Will • Retaining an attorney (required by Florida law) • Filing of a Petition for Administration with the proper Probate Court • Giving Notice to Beneficiaries under the Will or to statutory heirs (if no Will exists) • Filing a petition to appoint a Personal Representative • Preparation of inventory and appraisal of estate assets by
Personal Representative • Publication of Notice to Creditors in the local newspaper • Determination and payment of estate debts to rightful creditors • Payment of taxes, if applicable • Distribution of assets to beneficiaries or heirs
Probate administration is:
• Expensive. Typically 5% to 8% of the value of the assets in the estate. • Time-consuming. In south Florida, even the simplest probate administration takes up to 12 months or longer. • Open to the public. Court records may be viewed by all. Can probate administration be avoided?
Yes. You can own all assets jointly with others, or have all accounts established with designated beneficiaries. While this approach seems like the best and easiest solution, it may not be. Joint ownership or beneficiary designations severely limit your ability to control exactly who will receive your property, when they receive it, and how the property is to be managed. Moreover, if you have young or unsophisticated beneficiaries, their inheritance may be squandered, subject to creditors, or lost through divorce.
Creating and funding a revocable living trust is an excellent way to avoid probate administration. A revocable living trust allows you to control what you have so it is given to whom you want, when you want, in the way you want, and all at the lowest overall cost to you and your loved ones. There are situations, however, where a revocable living trust may not be appropriate. We recommend that you consult with an experienced estate planning attorney to explore all options and establish a plan that works for you. Life can change in an instant. What are you waiting for?
⊲ Bruce Iden earned his J.D. from George Washington University
National Law Center and his L.L.M in taxation from the University of
Miami School of Law. He has been practicing in the areas of estate planning, real estate and business law for over 30 years. For more information, or to schedule a consultation with Mr. Iden, contact
Iden Law Offices at 954-885-0085.
