Struggling With AFib? Go Set A Watchman
A minimally-invasive device can reduce the stroke risk for some atrial fibrillation patients
If you are dealing with atrial fibrillation—an irregular heart beat in the upper champers—and are also not able to take blood thinners safely on a long-term basis because of your job or another medical condition, you’re in quite an unfortunate Catch-22. The atrial fibrillation is increasing your risk of stroke, but the medication that could prevent the stroke is too dangerous to take.
But a new device can be your way out from between the rock and the hard place. It’s called the Watchman, and The Heart Hospital at St. Joseph’s/Candler is the only hospital in the region to offer it.
“The Watchman is ideal for a certain kind of patient,” says Arthur C. Kendig, MD, a clinical cardiac electrophysiologist. “It can help someone who has atrial fibrillation as well as other significant risk factors for a stroke, which would typically require them to take a blood thinner, but also have some reason—such as falls or a long term bleeding risk—that makes taking a blood thinner too risky long-term.”
AFib And Stroke Risk
Atrial fibrillation, also known as AFib, affects at least 2.7 million people in the United States. The primary and most feared risk of AFib is a stroke.
“When a patient is in atrial fibrillation, the top of the heart does not beat regularly or forcefully enough, and blood can form clots, especially in a sac-like structure called the left atrial appendage,” Kendig explains. “If those blood clots travel out of that structure, they can travel to the brain and cause a stroke. Other serious risks of atrial fibrillation include weakening of the heart muscle if the heart goes too fast for too long. Many people with atrial fibrillation have symptoms such as heart fluttering, shortness of breath, activity intolerance and fatigue, any of which affect their quality of life.”
Physicians can prescribe medications, and in some cases even just lifestyle modifications, that can help restore a normal rhythm or bring down a high heart rate. But patients will still be at risk from blood clots causing a stroke.
Blood thinners can prevent these clots from forming, but these may be too risky if a patient also has:
- gastrointestinal bleeding
- a brain bleed
- easy bruising
- high fall risk due to activity level or occupation
The Watchman device is designed to seal off the left atrial appendage, where the majority of blood clots form, and prevent strokes without long-term blood thinners.
The Quarter-Sized Umbrella
The Watchman procedure is minimally-invasive. The implantation of the device, which is about the size of a quarter, only takes an hour.
“The procedure is performed under anesthesia, with an ultrasound also used,” Kendig says. “The device starts out collapsed like an umbrella, and is inserted through a tube in the vein in the groin, advanced to the heart, crosses from the right to left side in the top of the heart, and is opened in the left atrial appendage.”
Dr. Kendig also uses ultrasound and X-ray to make sure the device is placed properly. Once the Watchman is opened in the appendage, other tests are performed to make sure it is stable and in the proper location. Then it is released to stay in the heart.
After the procedure, the patient is on bed rest for a few hours and watched overnight, and then usually discharged the following morning.
Patients are typically given a 45-day course of blood thinner medication after the implantation. After that time, more than 90 percent of patients who received the Watchman have stopped taking a blood thinner. Yet their risk of stroke remains drastically reduced. Clots are prevented from forming and breaking loose, and this Watchman never sleeps.
To learn more about the Watchman, visit www.sjchs.org/watchman.