Let WATCH­MAN™ Protect Your Heart

Atri­al fib­ril­la­tion (also referred to as a‑fib or AF) is one of the most com­mon types of abnor­mal heart rhythms. A‑fib affects near­ly 6.1 mil­lion peo­ple in the Unit­ed States today. ^1,2 A‑fib is caused by abnor­mal elec­tri­cal impuls­es that are gen­er­at­ed from the upper cham­bers of the heart (atria). It impairs the abil­i­ty of the atria to pump blood, and usu­al­ly caus­es the heart to beat too rapidly.

Approx­i­mate­ly a half mil­lion new cas­es of a‑fib are diag­nosed every year in the U.S., and bil­lions of dol­lars are spent annu­al­ly on its diag­no­sis and treat­ment includ­ing the more than 750,000 hos­pi­tal­iza­tions that occur each year because of a‑fib. A‑fib is a seri­ous con­di­tion that leads to an esti­mat­ed 130,000 deaths each year. A rate which has con­tin­ued to rise over the last two decades.^3,4

There are many caus­es of a‑fib. Fac­tors that con­tribute to a‑fib include:

• Age
• Dis­or­ders affect­ing the mitral valve of the heart
• Genet­ic predisposition
• Obe­si­ty
• Con­sum­ing alco­hol, caf­feine or tobac­co (these act as stim­u­lants to the heart)
• Sleep apnea and oth­er lung problems
• High blood pressure
• Hyper­thy­roidism
• Stress brought on by any severe illness

While it is pos­si­ble to have a‑fib with­out any symp­toms, most patients have symp­toms such as:

• Heart pal­pi­ta­tions (a sen­sa­tion that the heart is rac­ing or fluttering)
• Feel­ing faint or lightheaded
• Short­ness of breath
• Fatigue
• Chest pain or discomfort

If you are expe­ri­enc­ing any of these symp­toms, it is impor­tant to see your health care provider for fur­ther eval­u­a­tion. Even if you are not expe­ri­enc­ing any symp­toms, your provider could diag­nose a‑fib by find­ing an irreg­u­lar heart­beat dur­ing a phys­i­cal exam. 

Diag­nos­ing a‑fib is impor­tant because of the seri­ous health risks asso­ci­at­ed with the dis­ease, specif­i­cal­ly stroke and heart fail­ure. Patients with a‑fib are five times more like­ly to suf­fer a stroke than patients with a reg­u­lar heart­beat. This is because a‑fib caus­es blood to pool in the left atri­um of the heart, lead­ing to blood clots that can be pumped to the brain.

Tra­di­tion­al­ly, treat­ment for patients with a‑fib involved the long-term use of blood thin­ning med­ica­tions known as anti­co­ag­u­lants. Anti­co­ag­u­lants pre­vent blood clots from form­ing, and sig­nif­i­cant­ly low­er the risk of stroke. How­ev­er, anti­co­ag­u­lants may not be effec­tive or safe in some patients. Anti­co­ag­u­lants can cause an increased risk of bleed­ing. Thus, patients who are at a high­er-risk for bleed­ing, whether it’s due to a more active lifestyle, fall risk and oth­er fac­tors, may not be can­di­dates for anticoagulation.

The WATCH­MAN™ pro­ce­dure pro­vides patients with an alter­na­tive treat­ment option through a one-time, safe and effec­tive min­i­mal­ly inva­sive pro­ce­dure. It is the only FDA-approved implant proven to reduce the risk of stroke for patients with non-valvu­lar atri­al fib­ril­la­tion. The per­ma­nent implant works by block­ing access to the left atri­al appendage (LAA), which is locat­ed inside the left atri­um of the heart. More than 90% of stroke-caus­ing blood clots orig­i­nate in the LAA for indi­vid­u­als with non-valvu­lar a‑fib. The WATCH­MAN™ implant fits into the LAA and per­ma­nent­ly clos­es it off to keep blood clots from form­ing. The implant is light­weight and small, and is approx­i­mate­ly the size of a quarter.

Dur­ing the pro­ce­dure, a car­di­ol­o­gist implants the device by insert­ing a nar­row tube into a vein in the upper leg to gain access to the chest. The car­di­ol­o­gist then guides the WATCH­MAN™ implant into place in the LAA. The pro­ce­dure is done under gen­er­al anes­the­sia, and takes about an hour to com­plete. Most patients return home the next day.

Fol­low­ing the pro­ce­dure, patients will take war­farin (an anti­co­ag­u­lant) for about 45 days while heart tis­sue grows over the implant to form a bar­ri­er. The car­di­ol­o­gist will close­ly mon­i­tor this progress. Once the LAA has become com­plete­ly closed off, the blood thin­ner med­ica­tion can be discontinued.

Dur­ing a clin­i­cal trial:

• 92% of patients were able to stop tak­ing war­farin 45 days after the procedure
• 99% of patients were able to dis­con­tin­ue war­farin use with­in a year.

**A very small per­cent­age of patients may need to keep tak­ing blood thin­ners long-term.

The WATCH­MAN™ pro­ce­dure is a safe and effec­tive way to pre­vent strokes in patients with a‑fib. Cur­rent­ly more than 30,000 WATCH­MAN™ pro­ce­dures have been per­formed world­wide. As with any med­ical pro­ce­dure, there are risks asso­ci­at­ed with WATCH­MAN™. Your car­di­ol­o­gist will help you deter­mine if WATCH­MAN™ is an appro­pri­ate treat­ment option for you.

Always dis­cuss any heart-relat­ed ques­tions or con­cerns with your health care provider. Click here to sched­ule an appoint­ment with a DMG Cardiologist. 

Car­di­ol­o­gists at Duly Health and Care have been per­form­ing implan­ta­tion of the WATCH­MAN™ with suc­cess since 2017.

Ref­er­ences

Jan­u­ary CT, Wann LS, Alpert JS, Calkins H, Cig­a­r­roa JE, Cleve­land JC Jr, et al. 2014 AHA/ACC/HRS guide­line for the man­age­ment of patients with atri­al fib­ril­la­tion. Jour­nal of the Amer­i­can Col­lege of Car­di­ol­o­gy. 2014;64(21):2246 – 80.

Mozaf­far­i­an D, Ben­jamin EJ, Go AS, Arnett DK, Bla­ha MJ, Cush­man M, et al. Heart dis­ease and stroke sta­tis­tics-2015 update: a report from the Amer­i­can Heart Asso­ci­a­tion. Cir­cu­la­tion. 2015;131:e29-e322

Agency for Health­care Research and Qual­i­ty. Weight­ed nation­al esti­mates. HCUP Nation­al Inpa­tient Sam­ple [online]. 2012. [cit­ed 2015 Feb 9]. Avail­able from: http://​hcup​net​.ahrq​.gov/​H​CUPne… for Dis­ease Con­trol and Pre­ven­tion. About mul­ti­ple cause of death 1999 – 2011. CDC WON­DER Online Data­base. 2014. [cit­ed 2014 Oct 2]. Avail­able from: http://​won​der​.cdc​.gov/​m​c​d​-​i​c​d​1​0​.html.