August 27, 2018
People with atrial fibrillation (AFib) who are on the blood thinner warfarin (Coumadin) now have a better, permanent option to a daily pill, regular blood tests, dietary restrictions, and risk of falling. It’s called WATCHMANTM, a heart implant procedure performed by the Austin Heart cardiology team.
Austin Heart and Texas Cardiac Arrhythmia (TCA) cardiologists recently implanted their 225th WATCHMAN, a device for people with AFib not caused by a heart valve problem. This permanent heart implant effectively reduces the risk of stroke without the side effects of warfarin. Congratulations, Austin Heart’s Drs. Juhana Karha, interventional cardiologist, Paul Pagley, clinical cardiologist, and TCA electrophysiologist, Dr. David Tschopp.
How WATCHMAN Works
AFib affects the heart’s ability to pump blood normally. This can cause blood to pool in an area of the heart called the left atrial appendage (LAA). There, blood cells can stick together and form a clot. 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 AFib not caused by a heart valve problem, more than 90% of stroke-causing clots that come from the heart are formed in the LAA. The WATCHMAN implant fits right into the LAA and is designed to permanently close it off and keep those blood clots from escaping. WATCHMAN is about the size of a quarter and made from very light and compact materials commonly used in many other medical implants
The WATCHMAN Procedure
WATCHMAN is implanted into the heart in a one-time procedure. It’s a permanent device that doesn’t have to be replaced and can’t be seen outside the body.
To implant WATCHMAN, our Austin Heart team makes a small cut in the upper leg and inserts a narrow tube, as done in a standard stent procedure. The doctor then guides WATCHMAN into the LAA of the heart. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.
Due to the risk of having a medical procedure, patients should not be considered for WATCHMAN if they are doing well and expect to continue doing well on blood thinners.
After the Procedure
Following the WATCHMAN procedure, patients take warfarin for about 45 days or until the LAA is permanently closed off. During this time, heart tissue will grow over the implant to form a barrier against blood clots. Austin Heart doctors will monitor this process by taking pictures of the heart to see when taking warfarin can be stopped.
Patients are prescribed a medicine called clopidogrel (also known as Plavix®) and aspirin for up to take 6 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.
Who Qualifies for WATCHMAN
The WATCHMAN Implant may be right for people who meet the following criteria:
- They have atrial fibrillation not caused by a heart valve problem (also known as non-valvular AFib).
- They have been recommended for blood thinning medicines by their doctor.
- They can take warfarin but need an alternative.
People may need an alternative to warfarin for any one of these reasons:
- They have a history of major (serious) bleeding while taking blood thinners.
- They have a lifestyle, occupation, or condition that puts them at risk for major bleeding.
- They take warfarin and have trouble staying within the recommended blood clotting range (a measurement known as INR*) or getting regular blood tests to confirm their INR, and they cannot take a different type of blood thinner.
Check with your Austin Heart doctor to see if WATCHMAN is right for you.
Information source WATCHMAN