A Minimally invasive One-Time Implant that Helps Reduce AFib Stroke Risk
For people who have atrial fibrillation, or A-fib, blood clots that cause strokes are a danger. The WATCHMAN™ device permanently seals off the left atrial appendage, a section of the heart that is the site of almost all stroke-causing blood clots in people who have A-fib.
It’s the only FDA-approved device of its kind designed to prevent blood clots that form in the left atrial area from entering the bloodstream and causing strokes.
MercyOne Iowa Heart Center Electrophysiologist (heart rhythm expert) Robert Hoyt, M.D. was the first physician in Iowa to implant the WATCHMAN device to treat patients with atrial fibrillation (AFib) as part of the Prevail trial in 2012. We have done over 400 Watchman procedures with a combination of research and commercial cases - the largest volume in the state of Iowa. Drs.Hoyt, Hounshell, Dwayne Campbell, MD, and Mohit Chawla, MD, are the four implanting physicians and are on target to achieve a goal of 500 commercial WATCHMAN cases in early 2022.
How Does AFib Increase Stroke Risk?
The average person with atrial fibrillation (also called AFib or AF) is five times more likely to have a stroke than someone with a regular heartbeat. Afib affects more than 5 million Americans and is responsible for 15 to 20 percent of all strokes nationwide. That’s because AFib can decrease the heart’s pumping capacity by as much as 30%. Because blood isn’t pumped out of the heart normally, it’s easier for blood cells to stick together and form clots in an area of the heart called the left atrial appendage (LAA). When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.
In people with atrial fibrillation not caused by heart valve problems (the most common type of AFib), more than 90% of stroke-causing clots that come from the heart are formed in the LAA.
Reducing AFib Stroke Risk
Blood thinners, also called anticoagulants, are an effective way to lower the risk of stroke in people with atrial fibrillation not caused by heart valve problems.5 Common blood thinners include warfarin (also known as Coumadin®), Eliquis®, Pradaxa®, Xarelto® and Savaysa®.
But some people need an alternative to blood thinners, because they can increase the risk of bleeding. Some bleeding events are minor and easily treated, like a cut taking longer than normal to stop bleeding. In other cases, the bleeding can be life-threatening, such as when bleeding in the brain causes a stroke.
Watchman as an alternative to blood thinners
WATCHMAN is a permanent implant that offers an alternative to the lifelong use of blood thinners. It’s about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.
If you have a history of bleeding or a lifestyle, occupation or condition that puts you at risk for bleeding, your doctor may consider an alternative to blood thinners, such as the WATCHMAN Implant.
How WATCHMAN Works
WATCHMAN effectively reduces the risk of stroke by permanently closing off the LAA to keep blood clots from escaping. WATCHMAN can eliminate the bleeding risks and regular blood tests and food-and-drink restrictions that come with warfarin. In a clinical trial, 9 out of 10 people were able to stop taking warfarin just 45 days after the WATCHMAN procedure.
How is WATCHMAN Implanted?
WATCHMAN is implanted into your heart in a one-time procedure. To implant WATCHMAN, your doctor makes a small cut in your upper leg and inserts a narrow tube, as done in a standard stent procedure. Your doctor then guides WATCHMAN into your heart’s LAA. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.
After the Procedure
Following the WATCHMAN procedure, you’ll take warfarin for 45 days or until your LAA is permanently closed off. During this time, heart tissue will grow over the implant to form a barrier against blood clots. Your doctor will monitor this process by taking pictures of your heart to see when you can stop taking warfarin.
Your doctor will then prescribe a medicine called clopidogrel (also known as Plavix®) and aspirin for you to take for six months. After that, you’ll continue to take aspirin on an ongoing basis. A very small number of patients may need to keep taking blood thinners long term.
In a clinical trial:
- 92% of patients were able to stop taking warfarin just 45 days after the procedure
- 99% of patients were able to stop taking warfarin within 1 year after the procedure
For more information, call our WATCHMAN education specialist at (515) 229-7449.