WATCHMAN – An Alternative to Anticoagulants
WATCHMAN is a permanent implant that reduces stroke risk for people with atrial fibrillation (AFib). It’s about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.
Kettering Physician Network Heart and Vascular physicians began doing WATCHMAN Implant procedures at Kettering Medical Center in 2016 as an alternative for patients with AFib who are unable to tolerate anticoagulants (blood thinners) therapies long-term.
How does AFib Increase Stroke Risk?
The average person with atrial fibrillation, also called AFib, is five times more likely to have a stroke than someone with a regular heartbeat. 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.
Reducing AFib Stroke Risk
Anticoagulants are an effective way to lower the risk of stroke in people with atrial fibrillation not caused by heart valve problems. Common anticoagulants include warfarin (also known as Coumadin©), Eliquis©, Pradaxa©, Xarelto© and Savaysa©.
But some people need an alternative to anticoagulants 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 stoke.
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 anticoagulants, such as the WATCHMAN Implant.
How WATCHMAN Works
WATCHMAN effectively reduces the risk of stroke by permanently closing off the left atrial appendage to keep blood clots from escaping. WATCHMAN can eliminate the bleeding risks and the need for 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. To assure you are a candidate, you will have a transesophageal echocardiography (TEE). This is an outpatient procedure that involves a scope being placed through the throat to the esophagus. An echocardiogram or ultrasound for the heart is done to measure the left atrial appendage. This will ensure you are a candidate and help the physician pick the correct size WATCHMAN device.
How is WATCHMAN Implanted?
WATCHMAN is implanted into your heart in a one-time procedure. To implant WATCHMAN, your doctor inserts a catheter into a vessel in the groin area, as done in a standard stent procedure. Your doctor then guides WATCHMAN into your heart’s left atrial appendage. 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 an anticoagulant for 45 days or until your left atrial appendage is permanently closed off. During this time, heart tissue will begin to grow over the implant to form a barrier against blood clots. Your doctor will monitor this process doing another TEE 45 days after the procedure.
Kettering Physician Network cardiologists performing the WATCHMAN Implant procedure: