Watchman Left Atrial Appendage Closure

Any research on Afib and certain other arrhythmias will yield that the five times increased risk of stroke primarily concerns us as electrophysiologists. Indeed, there is no surefire way to remove clots that have already formed. Instead, we use an innovative medical device known as the Watchman to seal the clots within the LAA.

How the Watchman Works

Much like cardiac catheter ablation, we make a small incision in the groin through which we thread a spaghetti-like catheter. This catheter is snaked up to the heart via a vein and uses advanced imaging such as continuous X-ray or advanced ultrasound technology to verify its location. Once the catheter tip has reached the opening of the left atrial appendage, the Watchman device is deployed.

The Watchman looks much like a parachute with a metal lattice and is about the size of a quarter. It is deployed like a closed umbrella and opens as it emerges from the catheter. The Watchman is sized to the opening of the LAA and fits snugly over it. Over the next few weeks, scar tissue builds around the metal lattice, eventually creating a seal that the blood clots cannot pass through.

Once the device is securely in place, we can feel more confident about reducing or eliminating blood thinners as the heart’s primary source of stroke-causing blood clots has now been separated from the bloodstream. In fact, according to the clinical study for the Watchman, 96% of patients were able to stop blood thinners within 45 days.

Risks and Consideration of the Watchman Device

Of course, as with any procedure, there are risks and considerations to Watchman implantation. First, there is a small risk of excessive bleeding or infection at the incision site of the groin. This is usually well-managed. There is also the potential damage to blood vessels or the heart as the catheter is guided to the LAA. These are very rare. There’s also the possibility, about 4%, that the Watchman does not allow patients to get off their blood thinners. This consideration can be reduced with proper patient selection and a very experienced electrophysiologist. The Watchman has an overall major complication rate of about half a percent.

The most important next step is for anybody with Afib or other arrhythmias to visit a cardiac electrophysiologist and understand their condition and next steps. We look forward to welcoming you to our practice to offer a proper diagnosis and treatment guidance for any cardiac arrhythmias you may be experiencing.