But now, thanks to the use of the WaTCHMan Left atrial appendage Closure Device at eisenhower Health, a growing number of desert residents with aFib can safely stop taking prescription blood thinners, freeing them from the serious health risks and lifestyle limitations these medications can impose — and still lower their risk from stroke.
In fact, since eisenhower Board Certified electrophysiologists Leon Feldman, MD, and andrew Rubin, MD, began implanting the WaTCHMan in July 2018, more than 100 carefully selected patients have successfully undergone the minimally invasive procedure. Based on this volume, eisenhower is already the third-largest WaTCHMan implant program in southern California — a significant achievement in just over one year.
“We’ve had an overwhelming reception to our rollout of the WaTCHMan device,” says Dr. Feldman. He credits eisenhower’s leadership for recognizing the tremendous need for this resource and making the investment in the device. “We thought we might have 35 cases in our first year, but we’re at almost triple that, and there’s no let-up in demand,” he adds.
What You Need To Know About Atrial Fibrillation, Blood Thinners and the WATCHMAN Device
Atrial Fibrillation is a type of irregular heartbeat (arrhythmia) caused when the two upper chambers of the heart (the atria) beat unpredictably and sometimes rapidly. It’s the most common heart rhythm disorder in the United States, affecting an estimated 2.7 to 6.1 million people, according to the Centers for Disease Control and Prevention. As the population ages, this number is expected to grow. About nine percent of people aged 65 or older have AFib, while approximately two percent of people under age 65 have the condition. AFib impairs the heart’s ability to pump blood normally. As a result, blood can pool in an area of the heart called the left atrial appendage (LAA) and form a clot, which can travel to the brain and cause a stroke. This is why AFib patients require lifelong anticoagulation therapy — blood thinners — to reduce their stroke risk. This risk is significant. People with AFib can have a five times greater risk of stroke than someone without the condition. And large studies demonstrate that anticoagulation therapy reduces the risk of stroke in patients with chronic AFib by almost 70 percent.
But there’s a catch.
Long-term blood thinner use can cause excessive bruising and bleeding. For people at risk of falls, this is a major concern since the risk of bleeding may be greater than the benefit of stroke prevention. People who take the blood thinner warfarin (Coumadin®) are also at increased risk of hemorrhagic stroke — bleeding in the brain — if they don’t keep their warfarin levels within a tight range, which requires food-and-drink restrictions and regular blood tests.
Plus, if someone takes pain medication for other health issues — arthritis, for example, which tends to be more common as we age — it can promote gastrointestinal bleeding, which can be worsened by anticoagulation therapy.
It’s a real dilemma, and one that causes nearly half of people with atrial fibrillation who should be on a blood thinner to forego this medication and go without protection against stroke.
WATCHMAN offers another, safer option.
what you need to know about atrial fibrillation, blood thinners and the watchman device This permanent heart implant fits into the LAA to close it off. In people with AFib not caused by a heart valve problem, more than 90 percent of stroke causing clots that come from the heart are formed in the LAA. That’s why closing off this part of the heart is such an effective way to reduce stroke risk. WATCHMAN is about the size of a quarter and is made from very light and compact materials commonly used in many other medical implants. To place it in the LAA, the doctor makes a small cut in the upper leg and inserts a narrow tube (catheter) into the femoral vein, as is done in a standard cardiac stent procedure. Under X-ray and ultrasound guidance, the doctor then guides WATCHMAN to the LAA of the heart. The procedure is performed under general anesthesia and the typical procedure takes as little as 20 minutes. Patients usually stay in the hospital overnight and go home the next day.
Six weeks after implantation, an imaging test called a transesophageal echocardiogram (TEE) is performed to confirm that the WATCHMAN device is properly positioned and that the heart tissue has grown over the implant to form a barrier against blood clots.
At this point, the patient stops taking warfarin or whatever direct oral anticoagulation medication taken previously. Instead, the patient takes aspirin and clopidogrel (brand name Plavix®) for another four to five months. At the six-month post-procedure mark, the patient takes aspirin alone on an ongoing basis.
“There is a lot of patient interest in this procedure because anticoagulation drugs are so restrictive and concerning for someone with atrial fibrillation,” says Board Certified Electrophysiologist Leon Feldman, MD, Co-Director of Eisenhower’s Electrophysiology Laboratory.
“Considering that a twenty-minute procedure can eliminate a lifetime of having to take these drugs and still confer protection against stroke, it’s no wonder that WATCHMAN is so appealing,” he adds.
To learn more about Eisenhower’s WATCHMAN program, call 760.346.0642.
