Ashish Pershad, MD, is an interventional cardiologist at Banner – University Medical Center Phoenix. For more information on this topic, talk to your doctor or call Dr. Pershad's office at (602) 521-3090.
Question: I’m on warfarin and recently heard about a device that can reduce my risk of stroke. How do I know if it’s something that will help me?
Answer: Atrial fibrillation (AF) is the most common heart rhythm disturbance. AF increases stroke risk fivefold. AF affects 33 million people today. From this population of 33 million people there is a substantial number of patients whose AF is not caused by an artificial heart valve. In these patients with non-valvular atrial fibrillation, 90 percent of strokes are caused by blood clots in the left atrial appendage.
Strokes due to AF are often debilitating with a high rate of recurrence. Physicians prescribe blood thinners such as warfarin in an attempt to thin the blood and prevent these strokes. However, thinning the blood increases the risk of internal bleeding that can be life threatening.
For patients at risk of bleeding while on blood thinners, there is procedure offered as an alternative. The WATCHMAN is a simple, safe procedure with an overnight hospital stay. The WATCHMAN Device is a permanent implant designed to close the left atrial appendage in the heart in an effort to reduce the risk of stroke for NVAF patients. It has been proven in multiple studies to be as effective as warfarin and with a much lower bleeding risk.
Any patient with AF not caused by a heart valve problem can opt in for the WATCHMAN procedure. The center of Medicare services (CMS) has set requirements to encourage shared decision making between the cardiologist, referring physician and the patient. If you want to get off blood thinners to have this alternative treatment, you should discuss this option with your physician.