People with atrial fibrillation (AFib) are often at high risk for stroke. To reduce this risk, most are prescribed blood-thinning medications. This may not be the best option for everyone with AFib, however, due to the side effects sometimes caused by these medications.
As an alternative, the Temple Heart & Vascular Institute offers the WATCHMAN™ Left Atrial Appendage Closure Device. About the size of a half dollar, this implantable device can greatly lower the stroke risk for AFib patients and eliminate the need for blood thinners.
Temple recently implanted its 100th WATCHMAN device.
“Patients with AFib who are not treated with blood thinners can have as high as a 30 to 40 percent risk of stroke over a five-year period,” says Brian O’Neill, MD, Associate Professor of Medicine at Temple. “WATCHMAN can improve the quality of life in patients with AFib, because blood thinners can cause problems like excessive internal bleeding which can lead to hospitalization.”
How WATCHMAN Works
WATCHMAN works by sealing off the left atrial appendage (LAA) – the part of the heart where clots often form in patients with AFib. If these clots break free and travel through the blood stream, they can block a blood vessel in the brain and cause a stroke. WATCHMAN, which looks like a small mesh parachute, can prevent this from happening.
Doctors implant WATCHMAN by threading a catheter through a leg vein to the heart. They then make a tiny hole through the wall between the heart’s two upper chambers so the catheter can reach the LAA. The WATCHMAN is lodged in place there.
Within about a month, a layer of tissue grows over the implant, securing it in place. Patients take warfarin for 45 days, and then aspirin and clopidogrel for six months. After that, only a daily aspirin is needed.
The hour-long procedure to implant WATCHMAN is performed under general anesthesia and patients feel no pain. Most patients spend one night in the hospital and return to normal activities soon after the procedure.
“WATCHMAN is the only device available outside of clinical trials that has been shown to be similar to warfarin in the prevention of stroke in patients with AFib,” said George Yesenosky, MD, Director of Cardiac Electrophysiology at Jeanes Hospital. “If the left atrial appendage is sealed off, clots may still form, but you don’t have to worry about them getting out and traveling to the brain.”
About Atrial Fibrillation
Atrial fibrillation is the most common form of heart arrhythmia, affecting up to six million Americans. AFib occurs when an irregular electrical pattern in the heart causes the upper chambers (called the atria) to fibrillate, or quiver, very fast and irregularly.
AFib causes poor blood flow in the top half of the heart and can lead to blood clots, stroke, heart failure and other heart-related problems if not treated.
Some people with AFib don’t know they have it and don’t have any symptoms. Others may experience one or more of the following symptoms: irregular heartbeat, heart palpitations (rapid, fluttering or pounding), lightheadedness, extreme fatigue, shortness of breath, or chest pain.