As promised, here is some feedback from Dr John Foran's presentation as the Surrey ASG meeting this evening. Please understand that I have no medical training and that this feedback is based on my interpretation of what we were told.
Dr Foran explained the importance of anti-coagulation and the various options available to AF sufferers such as Warfarin and NOACS. He then described an alternative procedure - Left Atrial Appendage Occlusion and provided several statistics relating to procedures undertaken at the Royal Brompton and Harefield Hospitals since 2009. Details of these statistics will be sent to the meeting attendees and subject to approval, should be available to interested parties later. We were told that stroke protection was considered to be better than using conventional oral anti-coagulation.
Apparently, 90% of potential clots are formed in the Appendage, with the remaining 10% forming elsewhere in the Left Atrium. The procedure itself takes less than an hour and follows a similar process to a Catheter Ablation, however, the total time including preparation and recovery could be around 4 hours and may require an overnight stay. Patients are carefully monitored during the procedure to determine that the Appendage has been successfully sealed. The time patients have to remain on anti-coagulation is dependent upon the success of the sealing process and the time it then takes for a natural skin to develop and finally seal the area. In extreme cases, this may take a year, but more normally 3 to 6 months.
The success rates for the procedure were impressive, with no serious failures. However, access to the procedure is restricted to patients who are unable to take any form of oral anti-coagulation medication. This generally means patients who have experienced severe life threatening bleeding and/or serious heart conditions. Recently, funding for this procedure has transferred from local to central government control. Any request for a procedure is generated by the medical team and there is a formal process which has to be followed before funding is agreed. We were told that there may be changes taking place in the USA which may influence similar changes in the UK but that this may take time to materialise. Privately funded or health insurance funded procedures are unlikely to proceed because they are subject to the same criteria.
In summary, this is a successful procedure that will protect patients against the risk of stroke who cannot take conventional anti-coagulation medication, although this may change over time.
I hope this helps to answer some of the questions raised earlier.