WATCHMAN Implant Procedure
New Hope for Patients with Atrial Fibrillation
MidMichigan Medical Center - Midland offers patients with non-valvular atrial fibrillation (AF) an alternative to long-term warfarin (Coumadin®) medication with the WATCHMAN™ Left Atrial Appendage Closure (LAAC) Implant.
For patients with AF who are considered suitable for Coumadin by their physicians but who have reason to seek a non-drug alternative, the WATCHMAN implant is an alternative to reduce their risk of AF-related stroke. The WATCHMAN implant closes off an area of the heart called the left atrial appendage to keep harmful blood clots from the LAA from entering the blood stream and potentially causing a stroke. By closing off the LAA, the risk of stroke may be reduced and, over time, patients may be able to stop taking Coumadin and/or other blood thinners they may be taking such as a novel oral anticoagulant.
People with atrial fibrillation have a five times greater risk of stroke.1 Atrial fibrillation can cause blood to pool and form clots in the LAA. For patients with non-valvular AF, the LAA is believed to be the source of the majority of stroke-causing blood clots.2 If a clot forms in the LAA, it can increase one’s risk of having a stroke. Blood clots can break loose and travel in the blood stream to the brain, lungs, and other parts of the body.
What is Atrial Fibrillation?
Atrial fibrillation (AF) is a heart condition where the upper chambers of the heart (atrium) beat too fast and with irregular rhythm (fibrillation). AF is the most common cardiac arrhythmia, currently affecting more than five million Americans.3 Twenty percent of all strokes occur in patients with AF, and AF-related strokes are more frequently fatal and disabling.4,5 The most common treatment to reduce stroke risk in patients with AF is blood-thinning warfarin medication. Despite its proven efficacy, long-term warfarin medication is not well-tolerated by some patients and carries a significant risk for bleeding complications. Nearly half of AF patients eligible for warfarin are currently untreated due to tolerance and adherence issues.6
Is WATCHMAN Right For You?
You may be a candidate for Watchman if you can answer yes to the following questions:
- Do you have atrial fibrillation not caused by a heart valve problem?
- Has your doctor recommended that you take a blood thinner for your AFib?
- Can you take coumadin but need an alternative to long-term blood thinners for one of the reasons below?
- You have a history of serious bleeding while taking blood thinners.
- You have a lifestyle, occupation or condition that puts you at risk for serious bleeding.
- You’re taking coumadin and having trouble with your treatment plan, and a different type of blood thinner isn’t an option for you.
Cost and Coverage
WATCHMAN is covered for eligible Medicare patients who meet certain national coverage criteria. It’s also covered by an increasing number of commercial insurers.
With all medical procedures there are risks associated with the implant procedure and the use of the device. The risks include but are not limited to:
Accidental heart puncture, air embolism, allergic reaction, anemia, anesthesia risks, arrhythmias, AV (Arteriovenous) fistula, bleeding or throat pain from the TEE (Trans Esophageal Echo) probe, blood clot or air bubbles in the lungs or other organs, bruising at the catheter insertion site, clot formation on the Watchman Closure Device, cranial bleed, excessive bleeding, gastrointestinal bleeding, groin puncture bleed, hypotension, infection/pneumonia, pneumothorax, pulmonary edema, pulmonary vein obstruction, renal failure, stroke, thrombosis and transient ischemic attack.
In rare cases death can occur. Be sure to talk with your doctor so that you thoroughly understand all of the risks and benefits associated with the implantation of the Watchman Device.
About the WATCHMAN Procedure
WATCHMAN is implanted into your 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, your doctor makes a small cut in your upper leg and inserts a narrow tube, as done in a standard stent procedure. Your doctor then guides WATCHMAN into the left atrial appendage (LAA) of your 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.
How WATCHMAN Works
WATCHMAN™ is a trademark of Boston Scientific. Boston Scientific is a worldwide developer, manufacturer and marketer of medical devices that are used in a broad range of interventional medical specialties.
1. Holmes DR, Seminars in Neurology 2010; 30:528–536
2. Blackshear J. and Odell J., Annals of Thoracic Surgery. 1996;61:755-759
3. Colilla et al., Am J Cardiol. 2013; 112:1142-1147
4. Hart RG, Halperin JL., Ann Intern Med. 1999; 131:688–69
5. McGrath ER, Neurology 2013; 81:825-832
6. Waldo, AL. JACC 2005; 46:1729-1736