Most patients who suffer from Atrial Fibrillation/Afib or other supraventricular tachycardia are surprised to know that it is not the arrhythmia itself that we are most concerned about but the significantly increased risk of stroke, heart attack, and long-term heart failure. Indeed, because arrhythmias reduce the pumping efficiency of the heart, blood can begin to pool in a small outpouching of the heart known as the left atrial appendage or LAA, for short. Before minimally invasive treatment advances and catheter technology, patients would have to take antiarrhythmic and blood-thinning medications in perpetuity. While often effective, up to 50% of patients on medical therapy experience unacceptable side effects or do not get sufficient relief.
In the spirit of advancement and the treatment of significant potential risk with minimally invasive solutions, electrophysiologists like ours at Nevada Cardiology often use a clever medical device to seal the LAA and dramatically reduce stroke risk. This device, known as the Watchman, looks much like a parachute connected to a metal lattice. The Watchman fits snugly over the opening to the LAA and, over time, creates a strong barrier between the LAA and the rest of the left atrium.
How Is the Watchman Placed?
The Watchman is placed in an electrophysiology or EP lab. This is a special operating room set up for arrhythmia-specific catheter procedures. The patient is sedated, and a small incision is made in the arm or the groin. A small sheath used to guide the catheter is threaded up to the heart, via a blood vessel, and positioned in front of the LAA. At this point, the Watchman is deployed.
When the body detects a foreign object, it tries to absorb or isolate it by developing scar tissue – and this is precisely what we are looking for. Over the next several weeks, the body will develop scar tissue around the Watchman device, creating a strong and often permanent seal that keeps blood clots from the LAA filtered out of the cardiovascular system.
Of course, the watchman device does not treat the underlying arrhythmia. For these patients, an RF or cryo-catheter ablation can destroy the heart tissue causing errant electrical signals. One procedure does not necessarily preclude the other, giving appropriate patients maximum flexibility for long-term success.
If you are at risk of stroke due to Afib, we encourage you to make an appointment and learn more about your options and the best ways forward. From lifestyle change to curative procedures, our electrophysiology specialists have a wide range of options to handle any arrhythmia – straightforward or complex.