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I'm scheduled for the Watchman, assuming the CT scan shows that I am a candidate. However, I'm still on the fence about whether to go through with it. Here's why - I currently take Xarelto 20mg daily, which I tolerate well. But, I have an active lifestyle, bicycle riding, x-county skiing, hiking, furniture making (with power tools), cooking (with sharp knives), and more, all of which puts me at risk for bleeding. But the Watchman isn't a magic bullet. The procedure itself isn't risk-free, plus as some of these studies show, the device can leak and/or migrate over time, which may necessitate a more invasive procedure or the need to continue taking a DOAC. And who knows what the long term effects of a DOAC might be? Watchman or DOAC?...either path carries risks. While the doctor's recommend a DOAC based on my Chad score, they seem to regard the Watchman as elective surgery.
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@nevets
From my reading of the atrial appendage closure device studies I think they have a limited role for very few patients. They leak a lot, people still get clots, the studies exclude procedural bleeding and the doac arm includes bleeding that may not be a clinical disaster. I’m a fan of John Mandrola at medscape.org. His writing and podcasts are said to be for healthcare professionals only since he assumes his audience understands a lot of technical stuff. He rips apart the stats and methods on a lot of studies and ticks off a lot of people. He talks about your situation in his most recent podcast. He is very critical of the watchman trials, I think he has a point.
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@nevets ...in the same way a DOAC is elective.....................................................................true?