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PFA procedure with stroke risks

Heart Rhythm Conditions | Last Active: Jun 27 10:32am | Replies (31)

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Thank you also for your Watchman device comment. At my EP appointment yesterday ( which only lasts 15 minutes as expected), the EP said at the end of the appointment, OK, I will add the Watchman Device a the same time as the PFA procedure. I did not have any time to consider or research this device in any way. I do not know if it would be suitable for me or not. Some doctors do not advise it due to various risks (I have researched now). However, if the PFA controls the AFIB and puts my heart back in sinus rhythm, then maybe I don't need the Watchman? I am 76 and I read about the risks (appendage size, device related thrombosis, allergy to nickel/titanium or other device materials, cardiac tamponade, device dislodges etc). Unfortunately, it is difficult to talk to my EP, so I am trying to meet with his NP and another cardiologist, but I am afraid they will say it is my decision at the end. This is not calming or reassuring. Thank you so much.

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Replies to "Thank you also for your Watchman device comment. At my EP appointment yesterday ( which only..."

It's always your decision since it's your body and future at stake. The EP is just offering his/her studied advice based on their experience and learning.
The best EPs that I know of suggest a Watchman anyway, despite the success of previous or future ablations, because the disordered heart is permanently disordered. Just because the EP blocks the extra signals from causing your atrium to beat chaotically doesn't mean you don't still have that disordered state! And further, the disorder tends to progress for all but a very few people. This means that many of us, if not most of us, can expect to experience ectopy again in the future. For some, it happens inside of a year, for others it might be as long as ten years. But it happens so often that it's almost a given for the majority of AF sufferers: once you have it, you have it. And wouldn't it be better to have that Watchman insurance already in place? And save all the DOAC costs during the interim? If the Watchman shows no leakage at the 6 month point (done with a TEE) after a successful ablation, then you can opt to forego any further DOAC. At least, many EPs will agree to that.