Implantable device helps minimize stroke risk
Finally: An Alternative to Your Blood Thinners (Video)
Patients with atrial fibrillation (afib), the most common type of irregular heart rhythm, are five times more likely to suffer a stroke than those without afib. Advertising Policy Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy “Therefore, … Read More
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“Therefore, the most important aspect of afib management is the prevention of stroke,” says Oussama Wazni, MD, Director of the Outpatient Electrophysiology Department and Co-Director of the Atrial Fibrillation Stroke Prevention Center in the Cleveland Clinic Section of Cardiac Electrophysiology and Pacing.
Traditional treatments and a new alternative
Traditionally, stroke prevention in patients with afib has focused on anticoagulant therapy such as warfarin (also known as Coumadin®) to thin the blood and prevent clots caused by chaotic heart rhythms. These blood clots can break loose, travel through the bloodstream, and block a blood vessel in the brain. If this occurs, the part of the brain that is supplied by that blood vessel can become permanently damaged within minutes, which is known as a stroke.
Warfarin therapy requires close monitoring and blood tests, along with dietary restrictions. Newer blood thinners have been developed that do not require regular blood tests and dietary restrictions, however all blood thinners can cause harmful bleeding — most notably gastrointestinal (stomach/digestive system) bleeding; or even bleeding in the brain, which also can cause a stroke, Dr. Wazni explains. This can be of particular concern for patients who are at risk for bleeding to begin with. Therefore, researchers — including those at Cleveland Clinic — have been investigating alternatives to anticoagulant therapy.
In an exciting breakthrough, the U.S. Food and Drug Administration (FDA) recently approved one such alternative: the WATCHMAN® device, which is implanted percutaneously (through the skin) in the electrophysiology lab.
Dr. Wazni explains more about the WATCHMAN device and how it works in the video below.
Minimally invasive procedure
The device is implanted in the left atrial appendage (LAA) of the heart, the small, ear-shaped sac in the muscle wall of the left atrium (the top left chamber of the heart) where most blood clots caused by afib occur. The parachute-shaped, self-expanding device seals off the LAA to prevent any clots that may form from entering the bloodstream and potentially causing a stroke.
“This is actually a simple procedure, where we go in with catheters into the heart through a vein in the leg and implant the WATCHMAN device,” Dr. Wazni says. “If there’s a good seal, there’s a very high likelihood of coming off any anticoagulants.”
The WATCHMAN device has been approved by the FDA to reduce the risk of thromboembolism from the LAA in patients with atrial fibrillation that is not caused by heart valve disease who:
Cleveland Clinic electrophysiologists participated in clinical studies of the WATCHMAN prior to FDA approval, so they have more experience than most centers with the device.
Finding out if the WATCHMAN is for you
While the WATCHMAN device is an innovative new treatment that can benefit many patients, Dr. Wazni explains that appropriate patient evaluation and selection are extremely important.
If you or a family member are interested in treatment with the WATCHMAN device, you will need an evaluation by the physicians in Cleveland Clinic’s Atrial Fibrillation Stroke Prevention Center.
Some important information about the WATCHMAN procedure includes:
For more information, contact the Miller Family Heart & Vascular Institute at 216.445.9288 or toll-free at 866.289.6911.