New measures on stroke prevention

Chinese medical experts are working on reducing the risk of stroke among patients with non-valvular atrial fibrillation by using an innovative medical solution.

By closing off the left atrial appendage, the minimally invasive surgery can prevent the formation of blood clots and reduce the risk of long-term disability and death caused by thrombus embolization among atrial fibrillation patients.

Additionally, the solution can potentially eliminate patient dependence on long-term oral anti-clotting therapy. This is a new approach in the prevention of strokes among patients with atrial fibrillation in China.

Such surgery has recently been successfully conducted in Beijing Fuwai and Anzhen hospitals.

At the 2014 China Interventional Therapeutics Conference held in Shanghai in March, Ge Junbo, a doctor with Zhongshan Hospital affiliated to Shanghai-based Fudan University and a member of the Chinese Academy of Sciences, introduced the therapy through live broadcast of the operation procedure to the public for the first time in China.

According to figures from medical bodies, atrial fibrillation is the most common cardiac arrhythmia encountered in clinical practice. There are approximately 33.5 million people with the condition around the world, among which 8 million are in China.

AF patients have a fivefold risk of stroke compared to the general population. Furthermore, strokes caused by AF are generally more severe and result in higher mortality or recurrence rates.

In non-valvular AF, more than 90 percent of blood clots from the heart originates in the left atrial appendage. When AF occurs, the stagnant blood in the appendage becomes an ideal environment for a blood clot to form. If a blood clot lodges itself in the blood vessels of the brain, it can cause a stroke, according to Gao Runlin, an academic at the Cardiovascular Institute under the Chinese Academy of Medical Sciences.

Gao says many challenges exist in the prevention and treatment of the condition in China.

"First, because of the uncertain nature of the onset of the disease and its inconspicuous symptoms, the outpatient rate is comparatively lower. Second, patients who are intolerant, experience bleeding, resist taking medicines or have a condition that leaves them unable to take oral anticoagulant therapy are unable to adhere to long-term anticoagulant therapy," Gao says.

Research shows that only 5 percent of AF patients who suffered from an acute stroke received such anti-clotting therapy before hospitalization in China, according to Gao.

The left atrial appendage closure system created by Boston Scientific Corp has already been approved by China's State Food and Drug Administration.

"LAA closure is the new preferred therapy worldwide to reduce the risk of stroke in patients with non-valvular AF," Ge says.

"The launch of such a new system makes it possible for Chinese doctors to utilize this innovative technology in clinical applications. I hope that this surgery can provide Chinese physicians with references and inspiration for future applications."