Ask a nurse navigator: How does WATCHMAN help with AFib?

Non-valvular atrial fibrillation (AFib) can mean a lifetime of using blood thinners. It could also lead to concerns about scrapes, falls, and bleeding. With the WATCHMAN™ device, patients can have a safe and permanent alternative to blood thinners and a decreased risk of stroke. But what exactly is the WATCHMAN device? Our nurse navigator answers your most frequently asked questions:

1. How does the WATCHMAN device work?
2. Who should consider getting it?
3. Do all non-valvular AFib patients qualify for the device?
4. What is the recovery process like?
5. What am I allowed to do after the procedure?
6. Do I need to come back for follow-up visits or procedures?
7. How does the WATCHMAN device improve quality of life?
8. How long will the device last?

Keep on reading for the answers to these questions.

But first: Why is it important to treat atrial fibrillation? 

AFib is a condition in which the heart beats rapidly and irregularly. It negatively affects your heart’s ability to pump blood normally, causing blood to pool in an area of the heart called the left atrial appendage. The pooled blood cells can stick together and form a blood clot. These clots can escape from the left atrial appendage, travel to other areas of the body, and cut off blood supply to the brain, resulting in a stroke. 

1. How does the WATCHMAN device work?

More than 90% of strokes in those with non-valvular AFib are the result of blood clots formed in the left atrial appendage. The WATCHMAN device is an implant that seals off the left atrial appendage, blocking this avenue of clot formation in the heart, thereby greatly reducing stroke risk in those with atrial fibrillation.

Could the device ever get loose or migrate to other areas? 

While it’s possible for general LAA closure devices to migrate, it is an extremely rare occurrence. In a clinical study for this next-generation device, researchers reported a 0% rate of device embolization (device coming loose).

2. Who should consider getting the WATCHMAN device?

Those with non-valvular AFib who have concerns with taking blood thinners long-term should consider the WATCHMAN device. You should also consider this procedure if you have the following concerns:

• A history of bleeding episodes 
• A history of falls or an increased risk of future bleeding 
• A history of ineffective blood thinner usage as a stroke-prevention measure
• An active lifestyle or occupation that carries a risk of injury or bleeding 
• Difficulty keeping up with pill doses of once or twice daily 
• Food and medication interactions with blood thinners 
• Inability to afford the potentially high costs of blood thinner prescriptions 

3. Do all non-valvular AFib patients qualify for WATCHMAN?

There are very few factors that would lead to non-valvular AFib patients not qualifying for the WATCHMAN device. These include:

• Current blood clot in the heart
• Active infection
• Acute illness
   

Some factors are only temporary, and the decision to move forward with the WATCHMAN device can be re-visited once the issue resolves. More absolute factors would include the following:

• Anatomy that is incompatible with the device
• Inability to take blood thinners for a short period of time
• Inability to tolerate a cardiac catheterization procedure 

4. What is the recovery process like after having the device implanted?

The recovery from the WATCHMAN implant is shorter than other minimally invasive procedures that accomplish the same goal. Because the WATCHMAN procedure involves having the physician use the groin area as an access point, there will be bruising and tenderness at this site for a few days. 

Patients are up and walking within a few hours of completion of the procedure and oftentimes can go home on the same day with family or caregiver support.

- Scott Schexnayder, nurse navigator at St. Joseph Health Regional Hospital

5. What am I allowed to do after the procedure? 

After receiving the WATCHMAN implant, we advise patients to avoid the following activities for a few days: 

• Lifting anything greater than 10 lbs
• Climbing several flights of stairs
• Squatting 
   

These precautions are in place to protect the access sites at the groin. There are no specific limitations specific to the WATCHMAN device. These are general limitations for anyone undergoing any type of heart catheterization procedure. 

6.  Do I need to come back for follow-up visits after my procedure?

There are few follow-up appointments needed after getting the WATCHMAN implant. After around 45 days, patients return for a transesophageal echocardiogram (TEE), an ultrasound where the physician is able to obtain detailed pictures of the patient’s heart. During this imaging procedure, the physician gets a clear picture of the WATCHMAN implant and can determine whether the patient is able to stop their blood thinners. This is the case in over 96% of patients implanted with the WATCHMAN device.

Other follow-up appointments may be made at your physician’s discretion or the patient’s request.

7. How have lives improved after getting the WATCHMAN device?
Once patients don’t have to take their blood thinners, their quality of life can improve dramatically.

We see both physical and psychological improvements in patients who no longer have to experience the side effects or issues brought about by blood thinners. They are often able to confidently participate in activities and live active lifestyles.

- Scott Schexnayder, nurse navigator at St. Joseph Health Regional Hospital

8. How long does the WATCHMAN device last? Will it need to be replaced?
The WATCHMAN device is a one-time, permanent implant that never needs replacement. In fact, heart tissue will grow over the device, permanently sealing the left atrial appendage and preventing the collection of potential stroke-causing blood clots.

Patients with AFib and other heartbeat abnormalities and arrhythmias in the Brazos Valley can rely on our highly experienced electrophysiology team to provide innovative and compassionate care. Learn more about the WATCHMAN procedure by contacting our patient navigator today.

Sources:

American Heart Association | Primary Outcome Evaluation of a Next-Generation Left Atrial Appendage Closure Device
TCTMD | PINNACLE FLX: New-Generation Watchman Has High Closure Rates, Good Safety