A new implant device may be a breakthrough for reducing the risk of stroke for atrial fibrillation patients. The Watchman Left Atrial Appendage Closure provides a new option for patients with non-valvular atrial fibrillation who may require an alternative to long-term use of blood thinners.
The device is now FDA-approved in the United States and more widely available.
Currently, about 5 million Americans are diagnosed with atrial fibrillation, the most common cardiac arrhythmia where the upper chambers of the heart (atrium) beat too fast and with irregular rhythm (fibrillation). But having an irregular heartbeat is not the only challenge facing these patients. The condition causes them to be at a higher risk of experiencing a stroke — in fact, five times more likely compared to those without atrial fibrillation.
Because the heart does not beat properly in atrial fibrillation patients, blood may not fully pump out of the heart, causing it to pool and then clot in a pouch in the heart’s left atrial appendage. In some cases, the blood clots can break loose and travel in the bloodstream to the brain, resulting in a stroke.
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Along with putting patients at a greater risk of experiencing a stroke, the types of strokes caused by atrial fibrillation often are fatal or disabling.
In the past, the most common treatment to reduce the risk of stroke in these patients has been to have them take blood-thinning medication called warfarin.
Despite its effectiveness, taking blood thinners for long periods of time can be difficult for patients, because it isn’t always well-tolerated and it presents a significant risk for bleeding complications. Overall, about half of atrial fibrillation patients appropriate for warfarin go untreated due to their inability to tolerate or adhere to the medication.
For patients seeking an alternative to warfarin, the Watchman Implant offers a treatment option which could free them from the challenges of long-term blood-thinning therapy. The catheter-delivered heart implant is a one-time procedure that usually lasts about an hour.
During the procedure, the implant is designed to close off the left atrial appendage to prevent blood clots from entering the bloodstream that potentially could cause a stroke for higher-risk patients with non-valvular atrial fibrillation.
By closing off the left atrial appendage, over time, patients may be able to stop taking warfarin.
Dr. John C. Gurley is director of the structural heart program at the University of Kentucky HealthCare’s Gill Heart Institute.