Watchman Device Potential Alternative to Blood Thinners

People with atrial fibrillation – an abnormal, irregular heart rate – are at increased risk of stroke due to blood clots. The abnormal rhythm may cause blood to pool and form clots, mainly in a small chamber of the heart known as the left atrial appendage. To prevent these clots from forming, many atrial fibrillation patients considered at high risk for stroke are treated with blood thinning medications such as warfarin.

But there’s a catch: for many patients, taking blood thinners is problematic, due to bleeding issues or other health problems that interfere with the medication. For the right patient, a new device offers a potential alternative to long-term blood thinners. The device, called the Watchman, is a quarter-sized implant placed in the left atrial appendage of the heart. Once in place, it permanently closes off the appendage, preventing clots from escaping and causing a stroke.

WATCHMAN_device

Watchman Device Implant

The minimally invasive Watchman procedure is performed under general anesthesia through a catheter inserted in the groin. Patients typically leave the hospital the next day and quickly return to normal activities.

“The Watchman device is a great alternative for patients with a history of bleeding, frailty, falls, dementia or inability to maintain their target blood values on warfarin, despite their best efforts,” says Moses Mathur, MD, interventional cardiologist, Virginia Mason Heart Institute.

Patient Selection a Key to Success

While the goal of implanting the Watchman device is eliminating medications like warfarin, patients must be able to take a short course of blood thinners after the procedure until imaging tests show the appendage is permanently closed. After that, patients are transitioned to an aspirin regimen.

Other key criteria for Watchman candidates include:

  • Diagnosis of atrial fibrillation not due to a heart valve problem (such as rheumatic mitral stenosis, or presence of a mechanical heart valve)
  • Increased risk for stroke based on age and other current health conditions
  • Left atrial appendage anatomy compatible with the Watchman device
  • Ability to undergo an ultrasound scan of the heart (transesophageal echocardiogram), to ensure no existing clots are present and to examine the left atrial appendage during and after the procedure

Due to thorough patient assessments and the focus of an experienced team, Virginia Mason has an over 95 percent success rate implanting the Watchman device and eliminating long-term blood thinner regimens for patients.

“By assuming a small procedural risk up front, patients are offered the promise of being warfarin-free for the rest of their lives,” says Dr. Mathur. “And along with that comes fewer side-effects, less bleeding and less cost, year after year.”

Why the Heart Institute at Virginia Mason?

The Watchman procedure requires a heart team with expertise in structural interventional cardiology, where interventional cardiologists, electrophysiologists, imaging specialists and others work together to achieve the best outcomes for patients. This approach ensures every part of the procedure – from patient selection to post-procedure follow-up care – results in fewer complications and an optimal recovery.

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