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Left Atrial Appendage Closure Implant: WATCHMAN™

What is Atrial Fibrillation? 

Atrial fibrillation (Afib) is a medical diagnosis for a heart rhythm abnormality that causes the upper chambers of the heart to beat irregular. The irregular heart beat prevents blood from freely flowing to the lower chambers of the heart. When the heart is in Afib, it can cause a blood clot to form in the heart's top left chamber, typically in the left atrial appendage, which is the small sac in the heart's muscle wall. If a clot forms and breaks off in the blood stream it can travel to the brain and cause  a stroke. 

What are the Treatments Options for Atrial Fibrillation? 

Treatment options for Afib can be categorized to medications, surgical procedures, and non-surgical procedures. Medications for treating Afib may include drugs that control the heart rate and/or heart rhythm. Other types of medications may include blood thinners to prevent and treat blood clots. A surgical treatment option is the Maze Procedure. A Maze procedure is performed by a cardiac surgeon. The surgeon makes surgical patterns that form scar tissue to interfere with the transmission of electrical impulses that cause Afib. 

Non-surgical procedures for treating Afib may include electrical cardioversion, radiofrequency catheter ablations, cryo-ablations, and the WATCHMAN implant. 

Your treatment for Afib should be discussed and recommended by your doctor. 

What is a WATCHMAN Implant? 

The WATCHMAN implant is an umbrella-shaped device that is placed at the left atrial appendage through a catheter inserted into a large blood vessel. Once the WATCHMAN is placed, it seals the opening to this area preventing blood clot formation. Over time, new heart tissue grows over the implant and seals off the  appendage. This device reduces the risk for clots and may be an alternative to taking blood-thinning  medications for non-valvular atrial fibrillation. 

Am I a Candidate for a WATCHMAN Implant? 

The WATCHMAN implant provides an alternative to individuals unable to tolerate lifelong use of blood thinning medications for Afib. WATCHMAN is US FDA approved for reducing stroke in people with Afib not caused by valve problems. WATCHMAN may be used in individuals with: 

  • Atrial fibrillation not related to heart valve disease
  • At increased risk of stroke
  • Recommended for blood-thinning medications
  • Able to take a blood thinner for a limited period of time (Warfarin/Coumadin)
  • Have an appropriate reason to seek a non-drug alternative to Warfarin/Coumadin

As with any medical procedure, a consultation with your doctor is recommended to determine your management and treatment plan. 
* WATCHMAN is a trademark of Boston Scientific Corporation 

What Should I Expect if My Doctor Recommends an Evaluation for a WATCHMAN Implant? 

If you are unable to tolerate long-term blood-thinning medications for non-valvular Afib, your doctor will request an evaluation by a cardiologist trained in placing a WATCHMAN device. These cardiologists are specialized in electrophysiology (EP) or in interventional cardiology with advanced training. 

Preparing for the WATCHMAN Procedure 

Your physician will review your history, medications, and lab tests with you. Patients are commonly admitted on the day of the procedure. Instructions on preparing and arriving for the procedure are given in advance.

The procedure is performed in our state-of-the-art hybrid cardiovascular interventional lab under general anesthesia. 
 
To determine placement of the WATCHMAN device, a transesophageal echocardiogram (TEE) will be used to examine the structure of your heart and of the left atrial appendage. 

After Your Procedure 

An individual's recovery process may vary person to person depending on the person's health status prior to the procedure and any changes to medication. Many patients are discharged from the hospital the next day. However, some individuals may require an extra day or two of hospitalization to tailor required medical therapy. 

Although the goal of the WATCHMAN implant is to eventually discontinue blood-thinning medications, you will need to stay on these medicines after your procedure until follow up with your cardiologist. Once your cardiologist confirms blood-thinning medication is no longer required, you and your primary care doctor will be provided this information. While blood-thinning medication may be stopped, aspirin is usually continued. Use of aspirin and other medications will be prescribed by your doctor. 

You will receive a WATCHMAN Closure Device Implant Card. Carry this card with you at all times and show it when receiving medical care, dental care, or emergency care.

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