Atrial fibrillation (AFib) is the most common heart rhythm disturbance. If you have AFib, the upper chambers of your heart quiver or “fibrillate.” You may notice that your heartbeat seems rapid or irregular, and you may also have symptoms such as fatigue, dizziness, shortness of breath, anxiety and confusion. Some people with AFib don’t notice any symptoms, but their doctor diagnoses it during a physical exam.
The condition makes it more likely that you’ll develop blood clots in the heart that can cause a stroke. In fact, if you have AFib, you have a five times higher risk of stroke than people who don’t have the condition.
Why AFib increases your stroke risk
The changes in how your heart beats with AFib increase your risk of stroke. “With AFib, your blood tends to clot more and can collect in a pocket in the left upper chamber of the heart called the left atrial appendage, (LAA)” said Viet Tran, MD, an electrophysiologist with Banner Health. “This clot can then dislodge and travel through the blood vessels that connect the heart to the brain and cause a stroke.”
Strokes due to AFib are often debilitating, and people who have AFib-related strokes are likely to get them more than once. So, physicians prescribe blood thinners such as warfarin to thin the blood and prevent these strokes. However, thinning the blood increases the risk of internal bleeding, which can be life-threatening. So, many people seek alternatives for reducing stroke risk.
How an implantable device can help
There is an alternative for patients at risk of bleeding while on blood thinners. A left atrial appendage (LAA) closure procedure using the WATCHMAN device, which is implanted into the heart, gives you another option. The WATCHMAN is a permanent implant about the size of a quarter designed to close the left atrial appendage in the heart and keep the clots contained to that area to reduce the risk of stroke.
“This device has been shown in multiple trials to be a viable alternative to blood thinners for people who have atrial fibrillation, a significant risk of stroke and an elevated risk of bleeding on blood thinners,” Dr. Tran said. A WATCHMAN can help protect you from AFib-related stroke without needing to take the blood thinners that can increase your risk of bleeding.
It’s important to understand that the WATCHMAN doesn’t treat AFib. “It intends to protect patients from stroke due to atrial fibrillation,” Dr. Tran said.
Who should consider the WATCHMAN implant?
Anyone with AFib that’s not caused by a heart valve problem can consider the WATCHMAN procedure. You’ll want to talk to your cardiologist and referring physician to help decide if the WATCHMAN is right for you.
What does the WATCHMAN implant procedure involve?
The WATCHMAN insertion is a simple, safe, minimally invasive procedure, and most people can go home the same day. “WATCHMAN (and AFib treatments in general) are now very streamlined, low-risk procedures,” Dr. Tran said.
You don’t generally need to do anything to prepare ahead of time except stop taking blood thinners. You’ll be instructed not to eat or drink anything after midnight the night before your procedure. Since you’ll have anesthesia, you’ll need to arrange to have someone who can drive you home.
During the procedure, you’ll have general anesthesia. Your doctor will insert a catheter through a blood vessel in your groin, maneuver it to your left atrial appendage and place it there. The entire process takes about an hour. Afterward, you might need to lie flat to help reduce bleeding at the groin incision. You can usually get back to normal activities in a day or two, return to strenuous activity after a week and stop taking blood thinners after 45 days.
The bottom line
Many people with AFib take blood thinners to help reduce their risk of stroke. But blood thinners can increase your risk of bleeding. So, you may want to consider an implantable device called the WATCHMAN, which reduces your risk of stroke without the need for blood thinners.