How Does The Watchman Device for AFib Reduce Stroke Risk?

Editor's Note: September is A-Fib Awareness Month

It’s shaped like an umbrella, works like an umbrella, but it doesn’t go above your head like an umbrella.

Instead, this small, umbrella-shaped device is placed inside the left side of the heart in patients with atrial fibrillation (AFib) to reduce their risk of blood clots, stroke and heart failure.

It’s the Watchman Device, a new treatment for patients who have AFib not caused by heart valve disease.

The only FDA-approved device that reduces the stroke risk for patients with heart issues may offer an alternative for patients who are unwilling or unable to take blood-thinning medication due to risk of bleeding, risk of falls, or for patients who prefer non-pharmacologic treatment.

What is AFib?

AFib is an arrhythmia where part of the chambers of the heart fail to beat properly, according to Lee Physician Group cardiologist Erick Burton.

“The main pumping chambers of the heart, the ventricles, beat normally but the upper chambers are not beating at all. They’re fibrillating, resulting in a lack of synchronism between heartbeat and pulse,” Dr. Burton explains. “Atrial fibrillation is probably our most common type of chronic arrhythmia that causes problems for a lot of our patients.”

If left untreated, AFib greatly increases your risk of stroke or dying from a heart-related complication, according to the Centers for Disease Control and Prevention. Nearly 2.7 million people in the U.S. have AFib, and the number is expected to increase.

How does AFib lead to stroke?

When your heart doesn’t beat normally, blood stays inside the heart’s chamber too long. More specifically, this area of the heart where the blood pools is called the left atrial appendage, or LAA.

In the LAA, blood cells can stick together and form a clot. When a blood clot escapes from the LAA and travels to another part of the body, like the brain, it can cut off the blood supply, causing a stroke. In patients with AFib, more than 90 percent of clot-based strokes develop in the LAA.

Patients may experience AFib symptoms such as chest pain, dizziness, fatigue, shortness of breath—but others may have no symptoms at all.

“A lot of times the atrial fibrillation just hasn’t been recognized because it’s not causing any symptoms, Dr. Burton says. “It’s really important for us to try to be able to identify those patients who are in atrial fibrillation so that we can help direct them towards therapy that will make them feel better and reduce their risk of having a complication.”

People with AFib are five times more likely to suffer a stroke than other people. “Patients can have up to a 35 percent chance of having a stroke in their lifetime with atrial fibrillation if it’s not managed,” says Dr. Burton.

How is AFib treated?

“Atrial fibrillation affects people differently,” Dr. Burton says. “The optimal treatment for your AFib will depend on factors such as the underlying cause of your AFib, how severe your symptoms are, how long you have had the condition and any other health issues you may have.”

Blood thinner medications, also called anticoagulant drugs, are the most common treatment for AFib not caused by a heart valve problem, Dr. Burton says. 

But taking blood thinner mediation requires a daily – and potentially lifelong – commitment and requires frequent blood tests. Blood thinners (known medically as anticoagulants) also increase the risk of bleeding, a worrisome concern for patients who have a history of falls or blood-clotting problems.

And that’s where the Watchman Device has proved itself as an alternative, non-medication treatment that may allow users to stop taking blood thinners while still helping prevent blood clots from forming and leading to strokes.

How does the Watchman Device work?

In patients who are eligible for the procedure, Dr. Burton says a narrow tube (catheter) is inserted into the patient’s groin, as done in a standard catheterization procedure. The doctor then guides the tiny umbrella-shaped Watchman Device into the LAA of your heart.  

“The device is basically like a small little plug, and it's deployed through a catheter so when we release the device it expands, or opens like an umbrella,” Dr. Burton explains. “The device basically obstructs the area of the appendage and prevents clots from the inside getting out and blood from the inside getting in and forming more clots.”

The procedure is done under general anesthesia and takes about an hour. Patients typically stay in the hospital overnight and leave the next day.

Is the Watchman Device right for you?

The Watchman Device is for patients who:

• Have atrial fibrillation not caused by heart valve problems.
• Have been recommended to take blood-thinning medicines by their doctor.
• Can take blood thinners but need an alternative to blood thinners because they have a history of bleeding or a lifestyle that puts them at risk for bleeding.

The only way to determine if the Watchman Device is right for you is to consult with a Lee Physician Group Cardiology heart expert.

Our multidisciplinary team of imaging experts, electrophysiologists, interventional cardiologists, cardiac surgeons and other experts will listen to you, honor your preferences, and determine the best option that allows you to live a full, active life.