WATCHMAN: A new way to reduce stroke

More than 5 million Americans experience atrial fibrillation, including nearly one in 10 people older than age 65. Known as AFib for short, atrial fibrillation is a heart rhythm disorder, and it can result in a variety of serious medical conditions, including heart failure and stroke.

What can you do to try to prevent stroke if you have AFib? Blood-thinning medications work for a lot of people, but for many AFib patients, the medications are really not an option because of side effects. As many as 40 percent of AFib patients who are at high risk for stroke aren’t on medication, says Michael Robertson, MD, an interventional cardiologist and medical director of cardiology at Community Heart and Vascular Hospital.

WATCHMAN™ can Reduce Clots  

Fortunately, there’s a great new option called WATCHMAN™ Left Atrial Appendage Closure (LAAC) Device. Dr. Robertson explains that WATCHMAN goes right to the source of stroke risk for AFib patients. Blood clots are a leading cause of strokes, and for AFib patients, clots often develop in a certain part of the heart. “Clots tend to form in a muscle pocket in the left atrium for AFib patients,” he says. In fact, it’s estimated that 90 to 95 percent of the clots linked to AFib start out in this area.

“WATCHMAN is essentially a plug that is put into that muscle pocket to seal it off from the rest of the heart chamber,” Dr. Robertson explains. With that breeding ground for clots sealed off, the risk of stroke goes down significantly. It’s ideal for those who can’t take blood thinners—and for those who have been on blood thinners, WATCHMAN has often made the medications unnecessary.

The implant, made by Boston Scientific, was approved last year by the U.S. Food and Drug Administration (FDA). Earlier this year, Medicare began covering the procedure, and Community Heart and Vascular Hospital started serving WATCHMAN patients this past summer.

Patient Benefits

  • WATCHMAN is a one-time safe alternative procedure that reduces the risk of stroke in people with non-valvular atrial fibrillation.
  • WATCHMAN device is as effective at reducing the risk of stroke as warfarin (prescription blood-thinning medication therapy). But unlike warfarin, the WATCHMAN Implant also reduces the long-term risk of bleeding. Newer blood thinners offer an option to warfarin, but they don’t take away the long-term risk of bleeding.
  • In a clinical study 92% of patients were able to stop taking warfarin just 45 days after receiving the WATCHMAN Implant.
  • 99% were able to stop taking warfarin within a year after receiving it.

The Procedure

  • The WATCHMAN implant procedure is typically performed under general anesthesia in a catheterization laboratory setting using transfemoral access and a standard transseptal technique.
  • The WATCHMAN implant procedure usually lasts about an hour to 90 minutes and the patient is typically in the hospital for 24 hours.
  • Patients remain on warfarin for at least 45 days post-procedure until the device endothelializes.
  • By closing off the left atrial appendage, the risk of stroke may be reduced and, over time, patients may be able to stop taking anticoagulants.

Learn more about the WATCHMAN implant procedure in this video.

Krishna C. Malineni, MD

Krishna Malineni, MD, cardiologistDr. Malineni, board-certified cardiologist, joined Community Heart and Vascular in 2010. Previously, Dr. Malineni served as an electrophysiologist at Illinois Heart and Vascular in Hinsdale. He completed his fellowship in cardiology at the Rush University Medical Center in Chicago, Illinois and his fellowship in electrophysiology at Aurora Sinai Medical Center in Milwaukee, Wisconsin. He completed postgraduate training in internal medicine at Henry Ford Hospital in Detroit., where he was chosen as chief resident. Dr. Malineni attended Wayne State University, where he earned both his medical degree and bachelor of science in biology.

He is board certified in internal medicine, cardiovascular medicine and cardiac electrophysiology.

Michael A. Robertson, MD

Michael A. Robertson, MD, cardiologistDr. Robertson, interventional cardiologist, began his medical career in 2006. He served his fellowship in both cardiovascular disease and interventional cardiology at the University of Colorado. He also served his internship and residency in internal medicine at the University of Colorado. Dr. Robertson graduated from the University of Wisconsin School of Medicine.

He is board certified in internal medicine, cardiovascular disease and interventional cardiology.