What Is The Watchman Procedure?
WATCHMAN reduces stroke risk in people with atrial fibrillation not caused by a heart valve problem. It works differently from blood thinners like warfarin. WATCHMAN is a permanent implant that closes off a part of the heart where blood clots commonly form.
Watchman Procedure
The WATCHMAN Implant is placed into your heart using a minimally invasive procedure in a cardiac catheterization laboratory or electrophysiology laboratory by a physician and his/her team who have experience and training in the WATCHMAN implantation technique. In preparation for the implant, you will be lying on your back 011 a table while you are continuously monitored throughout the procedure by medical personnel. X-rays and echocardiograms (a special type of ultrasound picture) will be used to help visualize the heart while the implant is being advanced into the correct position in your heart. Contrast media (dye) will also be injected to help guide the implant placement. You will be given a general and/or local anesthetic by your doctor to minimize any discomfort during the procedure. Discuss the anesthesia method that is best for you with your physician.
A small puncture is made into a vein in your groin. A long, thin tube, called a catheter, is inserted into the vein and advanced into the right atrium of the heart. Another puncture is made through a thin muscle wall between the right atrium and the left atrium so that the catheter can be advanced into the left atrium. A thinner catheter is then advanced into the left atrial appendage under X-ray guidance.
The WATCHMAN Implant is tightly compressed within the catheter and is passed through the catheter into the left atrial appendage. The physician will make sure that the implant is in the right place within the left atrial appendage and then deploy the implant {much like opening up a folded umbrella). After the procedure, the WATCHMAN Implant is the only material that remains in the body. A thin layer of tissue will grow over the surface of the WATCHMAN Implant within about 45 days.
Watchman Recovery
After WATCHMAN is implanted, you will rest in the hospital where you will be monitored during your recovery. It may be one or more days before you are discharged home, and your doctor will determine how long you need to be in the hospital. Your doctor will instruct you to take warfarin and aspirin after your implant.
After your WATCHMAN Implant has been in place for a minimum of 45 days, your doctor will take pictures of your heart by means of a test called a TEE (transesophageal echocardiogram) to determine if the implant has closed the opening of the left atrial appendage. Your doctor may stop your warfarin medication at that time, depending on the result of this test. If your doctor chooses to stop your warfarin he/she will prescribe a new blood-thinning medication called clopidogrel (Plavix®) until 6 months after your implant procedure, and your aspirin dose may increase.
Watchman Results
At about 12 months after your WATCHMAN Implant, your doctor will schedule another TEE to check on the device. This is to ensure that your LAA is still closed. If the TEE that is performed at around 45 days shows that the opening of the left atrial appendage is not adequately closed, another TEE may be scheduled at around 6 months to re-evaluate whether adequate closure of the left atrial appendage has occurred.
It is extremely important for you to take the recommended medications (warfarin, clopidogrel, and aspirin) at the recommended time. If you stop taking these medications or change their dosage before being instructed to do so by your doctor, the chances of blood clot formation, subsequent stroke, or even death are increased. Talk to your doctor before stopping your medications or changing the dosage.
Watchman Benefits
The potential benefits of the WATCHMAN Implant for a patient with atrial fibrillation without heart valve disease are as follows:
- Reducing the risk of stroke from a blood clot originating in the left atrial appendage
- Being able to stop long-term warfarin therapy and a reduction in the risks associated with long-term warfarin use
In all of the WATCHMAN® clinical trials, approximately 92% of patients were able to stop taking their warfarin 45 days after implant, and over 99% were able to stop taking warfarin by 1 year following the implant procedure.
Watchman Device Risks
As with any procedure, there are risks associated with the implant procedure itself. There are also risks with the medications that are prescribed during and after the implant procedure. You should discuss with your doctor if these risks outweigh the benefit you may receive from a WATCHMAN Implant.
Frequently Asked Questions
Can The Watchman Implant Move Or Rust?
Once positioned by your physician, the implant should not move on its own. It is manufactured so it will not rust.
Can I Walk Through Metal Detectors With The Watchman Implant?
Yes, without any fear of setting them off.
How Soon Can I Resume Normal Daily Activities?
The majority of people return to normal daily activities within a few days following the procedure. Check with your doctor before resuming your usual activities.
What If I Experience Pain?
If you experience pain, immediately inform your doctor or the center where the procedure was performed.
Schedule A Consultation
To learn more about the WATCHMAN procedure or to schedule a consultation at one of our offices in Long Island or Queens, contact Premier Cardiology Consultants at (516) 437-5600.
