1. < Heart Rhythm Conditions

Any experiences with Watchman Implant for A-Fib?

Posted by Tresjur @tresjur, Oct 5, 2017

I've been living with A-Fib for close to 20 years now. I took warfarin for 14 of those years and then switched to Pradaxa. After being on Pradaxa for 8 months, I started having GI bleeds and over the course of 14 months I had 8 blood transfusions. After ending up with a hemogloblin count of 5 and
an INR of 9, I ended up in ICU. After my release, and lengthy discussions with my cardiologist, we decided that my body could no longer tolerate the
blood thinners. For three years I went without any A-fib treatment and a year ago I started taking a full dose aspirin daily.

Early this summer I saw the TV ads for the Watchman, for people who cannot take blood thinners. It's an jellyfish looking implant that is inserted in the
left atrial appendage of the heart. After implantation, heart tissue will grow over the device and provide blockage of clots that could travel to the brain.
I had the implantation done on September 13th, which requires an overnight stay in the hospital, and will be on Eliquis and an aspirin for about 45 days, then I will just take an aspirin daily for the rest of my life.

From reading the pros and cons of this device, it is my understanding that it does not work any better than blood thinners, but is an option for those who
cannot take the thinners. My first visit with the electrophysiologist is 2 weeks from today and at the end of October, I will undergo another TEE to determine
if all is working well.

I lived the 3 plus years not being on blood thinners with the though of stroke in the back of my mind. Even though I realize that nothing is 100% guaranteed or successful, I do have some relief now that I am again under treatment.

I'm posting this experience and wondering if anyone else has undergone this procedure and may be further along in their journey. It has been only 22 days
since my implant. I'm doing well so far and have not had a problem with the Eliquis so far.

Regards,
Mary

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Oct 8, 2018
In reply to @iowafemale "For those on Warfarin who find monitoring INR levels a pain, I used to. It involved..." + (show)
@iowafemale

For those on Warfarin who find monitoring INR levels a pain, I used to. It involved a drive to a local lab, being poked in my only good vein and a drive home. I didn't know for a few years that there is a home monitor that only requires a finger stick (a little more blood than a blood sugar poke). I've been doing that for a few years now. It's been really helpful when I am put on an antibiotic or other drug that may interfere with the INR. I can do extra tests as directed by my cardiologist without the hassle. I've found it to be pretty accurate and certainly easy to use. Results are entered online or by phone.

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@iowafemale

Welcome to Connect, I see that this is your first post.

Thanks for sharing that information, it sounds like a very convenient way to keep track of the INR levels.

Did you need a doctor's prescription in order to obtain this device? Are the test strips involved, like a diabetic testing kit?

REPLY
1 reply
iowafemale | @iowafemale | Oct 8, 2018
In reply to @hopeful33250 "@iowafemale Welcome to Connect, I see that this is your first post. Thanks for sharing that..." + (show)
@hopeful33250

@iowafemale

Welcome to Connect, I see that this is your first post.

Thanks for sharing that information, it sounds like a very convenient way to keep track of the INR levels.

Did you need a doctor's prescription in order to obtain this device? Are the test strips involved, like a diabetic testing kit?

Jump to this post

Yes, just a doctor's prescription. And there are test strips that are shipped to you by Roche.

My first post. Just joined Connect although I have been a Mayo patient for ten years, since a-fib was diagnosed. I've had two ablations (Dr. Munger is awesome!). The second one three years ago with no recurrence (yet).

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1 reply
Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Oct 8, 2018
In reply to @iowafemale "Yes, just a doctor's prescription. And there are test strips that are shipped to you by..." + (show)
@iowafemale

Yes, just a doctor's prescription. And there are test strips that are shipped to you by Roche.

My first post. Just joined Connect although I have been a Mayo patient for ten years, since a-fib was diagnosed. I've had two ablations (Dr. Munger is awesome!). The second one three years ago with no recurrence (yet).

Jump to this post

@iowafemale
I'm glad to hear that you are doing so well! Thanks for all of the interesting information about home testing for INR levels.

REPLY
Tresjur | @tresjur | Oct 13, 2018
In reply to @1943 "I was just in the hosp a few days for observation and then close follow up..." + (show)
@1943

I was just in the hosp a few days for observation and then close follow up with several cat scans. Also very close follow up with a neurosurgeon. It has been 4 months and I was without a blood thinner it was just recently decided the watchman was the procedure that was needed I am on eliqui s again for a short time but should not need abloo d thinner when heart heals over the watchman .

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Dear 1943,

I've just passed 13 months since I had the Watchman installed and I have been doing great. I had gone 3 years without any treatment for the A-Fib and at the same time living with the fear of a possible stroke. I cannot vouch for the long-term, but for now, having the Watchman has taken the stroke worry off my plate. I had no problem with the Eliquis when I was on it and I now take the low dose aspirin daily. I pray that the Watchman implant was the right treatment for you as it has been for me.

Mary

REPLY
1943 | @1943 | Oct 13, 2018

So had to hear you are doing well after the watchman procedure. It is so good to know there is something out there for those of us that can't take blood thinners.

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bjme | @bjme | Oct 14, 2018

Mary, Please keep us updated. Thank you so much for sharing

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mrk4445 | @mklapperich | Oct 14, 2018

Thanks everyone...it's Always a wait and see what happens... appreciate the in put

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1943 | @1943 | Oct 31, 2018
In reply to @tresjur "Hi Billie, Because it has been less than a month since the Watchman was implanted, I..." + (show)
@tresjur

Hi Billie,

Because it has been less than a month since the Watchman was implanted, I don't have much to offer in the way of pros or cons on its effectivity. For three years I was on nothing and then on 325 mg aspirin in the last year. What do you do when it seems your only option is to either bleed out or stroke out? Extremely scary worrying about either.

My decision to go with the Watchman was primarily to prevent clots and secondly to give me a little peace of mind from worrying about a stroke. Strokes (not A-Fib related) run in my family. I know what the quality of life is like after suffering a debilitating stroke from watching my aunt and grandma go through it. My primary care physician is happy with my decision as she had been worried about me not being on a thinner.

Your doctor will order a TEE to determine if you are an eligible candidate. The doctor will be looking for clots (hopefully none) and the size of the implant site to determine if the device will fit. Once I passed the TEE, because of my history of GI bleeds, I then saw my GI doctor who scheduled a colonoscopy and upper GI endoscopy looking for any areas that might bleed as I would again be on blood thinners. Two weeks before the procedure I went on coumadin, which was managed by an anticoagulation team that was in contact with me daily. My INR goal was 2.0 to 3.0 and but I never hit that mark. From day one, my INR was all over the place, but luckily after pigging out on leafy green vegetables the day before the implant, my INR went down to 3.0, and just prior to implantation it was a 1.9.

I stayed in the hospital overnight with hourly checks on the groin (incision site) and the stitches were removed the same day as the procedure. The incision site was rather painful that first day, but on the second day, the pain was down to a level 4. All looked good so I went home around noon.

I wanted to share my journey with you, however your journey may be different based on your current condition. I do know for sure that the initial TEE, and going on a blood thinner before and after the implantation is a requirement.

My suggestion to you is to do your due diligence, research, ask questions, and weigh the pro and cons. I even watched the procedure on YouTube...it's amazing what is on YouTube, lol. What had me on the fence is finding out the Watchman can only be removed with open heart surgery. I pray that it never comes to that. Because I felt that I had really pushed my luck for four years without any treatment for the A-Fib, I decided I had to do something and for me the pros won.

My thought are if my body would/could tolerate the thinners I would stay on them, even with the dangers involved. I'm an advocate for "if it ain't broke, don't fix it." I was doing fine on coumadin for 14 years then I switched to Pradaxa simply to avoid having to go for PT/INR testing. That's when I ran into low hemogloblin and GI bleed problems. So far I haven't had any problems with the Eliquis and should be off of them in another 25 days.

Regards,
Mary

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Hi Mary. Did you have the tee done yesterday? I will be having the echo done Nov 7th to see how the watchman is doing?

REPLY
Tresjur | @tresjur | Nov 1, 2018

Hello 1943,

The last TEE I had was back in September 2017 shortly after I had the Watchman implanted. In March of this year, the electrophysiologist released me to my cardiologist for further care. Since that time I have had an ECHO and all seems well.

Mary

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kathe626 | @kathe626 | Nov 7, 2018

I had the watchman inplanted on 22 July. Follow up TEE September 4 , all was fine so finally off Xaralto after 5 years now on Plavix until re-peat TER. If all good - then ASA Forever. My electrophysiologist had suggest this 5 years ago because of a Chad score of 5 and an extremely active life style (sling, biking, hiking,gardening) and terrible bruseing in response to the Xarelto. So far all is fine with the watchman. Still brushing with the Plavix but the bruises seem to go away after 3 weeks. Looking forward to January and no more blood thinners. Also had nose bleeds all the time on the Xaralto and so far only 2 since the Watchman. Good luck to you. Kathe Coelho

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