WATCHMAN Procedure for Atrial Fibrillation

a-fib is short for atrial fibrillation

it's the most common heart rhythm

disturbance it affects millions of

people it can make some people feel

poorly with the heart beating funny but

it increases the risk of stroke your

risk of stroke on average is 5 times

higher than the average population once

you have atrial fibrillation most eight

atrial fibrillation patients need to be

on blood thinners to prevent stroke and

that's what how most people are created

however every once in a while some

patients have bleeding complications or

are at increased risk of bleeding for

them a second option is something called

a left atrial appendage occlusion it's a

procedure that enables them to come off

blood thinners eventually the procedure

that is an option and alternative to

blood thinning medication for patients

to allow them to still have protection

against stroke is called a watchman and

it's a device that can be put in the

left atrial appendage of the heart that

is the part of the heart where blood

clots typically form with patients in

atrial fibrillation

so as an alternative to being in a blood

thinner it's a device I can be put in

there through a tube that is put in the

vein in the leg a tubing from there can

be placed into this appendage and the

watchman is a device that has a metal

frame shaped like a parachute with a

material coating once the tubing is put

into the appendage that device can be

compressed run up through the tubing put

into the appendage and when it's in the

proper location through which we define

through imaging and ultrasound imaging

of the heart the tubing is simply pulled

back to allow the device to expand out

when it's expanded it actually

obliterates the blood flow into the

appendage so now there is no way for a

blood clot to come out of that appendage

and actually over a period of time in

fact the appendage is totally sealed so

there's no blood flow in there at all

once that has been accomplished then the

only blood thinner that patients need

long-term is aspirin therapy so it's an

invasive procedure where we're putting

something something mechanical in your

heart the risk the day you have it done

is in the one percent vicinity that

includes perforation of the heart with

bleeding around it or the device

dislodging or stroke but all the bad

things together are about 1% the day of

implant then patient needs to be on

blood thinners for a few weeks while the

device heals so during that time you're

still vulnerable for bleeding which is

why most patients get this device so you

take a small risk of bleeding for a few

weeks to benefit from reducing risk of

stroke and not need blood thinners long

term after the procedure is done most

patients are in the hospital only for an

overnight observation and at that point

can be discharged to home with pretty

much getting back to normal routine and

activity level they stay on their blood

thinners usually aspirin and coumadin

for up to six weeks and then after six

weeks we do another ultrasound study of

the heart to make sure that the device

has completely sealed the appendage at

that point if it is confirmed patients

are taken off their coumadin and then

used another less aggressive blood

thinner for a period of four months and

at that point simply on aspirin therapy

alone we typically do office visits with

patients at six weeks after the implant

and at six months and then yearly

thereafter patients coming to spectrum

can expect all aspects of their atrial

fibrillation taken care of we have a

team of electrophysiologists that

perform hundreds of ablation the air for

patients who have symptoms from afib

their risk of stroke can be addressed

with blood thinners or a few of them

will end up needing the watchman device

and this multidisciplinary approach will

have patients better covered when when

they come to an institution where we can

take care of all of those things at the

same time