Patients living with non-valvular atrial fibrillation (AFib) now have access to a new treatment option that significantly reduces the risk of stroke. WellStar Kennestone Hospital is one of the first to offer the treatment publicly in Georgia. The WATCHMAN device is designed to keep harmful blood clots from entering a patient’s blood stream which could potentially cause a stroke.
AFib is the most common heart rhythm problem and studies have found that a third of people living with the untreated condition experience a stroke. Studies have also found that AFib-related strokes are more frequently fatal and disabling.
“Approximately 90 percent of strokes in individuals with AFib originate from blood clots that have formed in the left atrial appendage,” said Amar Patel, M.D. co-medical director of WellStar’s Structural Heart & Valve Program. “The WATCHMAN device plugs off the left atrial appendage (an unnecessary tissue structure in the adult heart), thus preventing clot formation and entry into the bloodstream.”
Anti-coagulants or blood thinners – such as warfarin – are often effective at curbing this type of stroke. However, some patients with AFib are unable to tolerate long-term anti-coagulation for various reasons, including previous gastro-intestinal or intracranial bleeding, those who work with heavy machinery or those who are at high risk of falling. In this case, the WATCHMAN device is a highly effective treatment option as an alternative to long-term anticoagulation.
“Traditionally these patients have had to make a choice between protecting themselves from a stroke and increasing their risk of bleeding from the medication,” Patel said. “With the WATCHMAN device, the majority of patients can typically stop using blood thinners after 45 days.”
Patients with non-valvular AFib with certain risk factors such as increased age, congestive heart failure, high blood pressure, vascular disease and prior stroke are typically considered candidates for the procedure.
The 1-1½-hour procedure is minimally-invasive and is performed by a multi-disciplinary physician team including an interventional cardiologist, an electrophysiologist, an interventional echocardiographer and an anesthesiologist. Because the left atrial appendage is shaped and sized differently in different people, ultrasounds help the team take measurements to choose the appropriately sized device. While the patient is under general anesthesia, the physician team guides the WATCHMAN device into the heart through a flexible tube that travels from a vein in the upper leg.
“Folks are typically discharged after only one night,” Patel said. “Patients feel great the next day and are ready to go home. It’s a great thing to see.”
After 45 days, there is a 92 percent success rate for patients coming off of warfarin therapy. For the remainder of the patients, it typically just takes a little more time. After a year of healing, greater than 99 percent of patients studied were able to come off of warfarin therapy.