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

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obdoc2001 | @obdoc2001 | Sep 16, 2022

In reply to @oldandintheway "On blood thinners since 2005 with atrial fib, 3 stents, several ablations and cardioconversions. On Eliquis..." + (show)

Best wishes.

realitytest | @realitytest | Sep 17, 2022

In reply to @oldandintheway "On blood thinners since 2005 with atrial fib, 3 stents, several ablations and cardioconversions. On Eliquis..." + (show)

I myself am looking into having a Watchman procedure performed.

I certainly wish you all the best, but do be aware that the Watchman is not designed to eliminate AFIB but rather to allow you to avert strokes without taking blood thinners (after that initial healing period).

I decided to have a Watchman because blood thinners carry with them a special added risk to my wet macular degeneration (they add risk for the retinal bleeding which is what kills the macular cells and leads to blindness).

There are other significant advantages to avoiding blood thinners too:
if you have a hemorrhagic stroke, while taking them you are pretty much a goner as the reversal agents are few and far between (even if you were able to get to a hospital carrying them in time, the cost is $25K for the first dose, and another $25K if you need another. The cost is the main reason hospitals don't carry it).

Also, anything causing bleeding, is hard to control while taking blood thinners.

Many doctors advise against older people taking them , because of their greater fall risk (especially because they might cause cerebral bleeding).

So you will end up ahead no matter what even if you continue to have Afib.

Best of luck1

oldandintheway | @oldandintheway | Sep 19, 2022

In reply to @realitytest "I myself am looking into having a Watchman procedure performed. I certainly wish you all the..." + (show)

Thanks for your comments and info. Something new comes out all of the time. I hope the Watchman is a presently good choice for those of us affected. I've lived with Afib for almost 12 years. Eventually, one ceases to worry about it....

sarahmckenna | @sarahmckenna | Nov 5, 2022

In reply to @realitytest "I read your description carefully (I believe you are the contributor who described his surgery in..." + (show)

Is it better to go to Cleveland clinic or Mayo for watchman procedure.
Is it dangerous and have they improved device to rid of complications

debithejedi | @debithejedi | Dec 28, 2022

In reply to @phoenix1647 "I was on thinners a few years ago but have developed internal bleeding so had to..." + (show)

I, also, was on blood thinners for many years and was given 4 units of packed red cells when my hemoglobin dropped to 3.7. They could not find why the loss of blood after a week of testing in the hospital. I even had a bone marrow biopsy. This was 3 months after I was hospitalized with covid back in 2020. Over the next few months my hemoglobin continued to drop, so I decided to make an appt with a GI Dr. He found multiple arteriovenous malformations in my small intestines and cauterized them. I have not had an incident of blood loss since then. Since there was a history of blood loss my cardioelectrophysioloist suggested a Watchman implant. I was thrilled that I could come off Xarelto. Had the implant without incident and went home the next morning. Continued on antiarrythmic for 5 more months and have not needed anything other than 81mg Aspirin daily since then. Had an ablation at the time of the implant. Now I'm suffering with pulmonary hypertension and grade 3 diastolic dysfunction, which has nothing to do with heart rythym, but was there the whole time and Dr didn't catch it. I finally went to a pulmonary Dr regarding my shortness of breath. Through many rigorous testing I was then diagnosed.

debithejedi | @debithejedi | Dec 28, 2022

In reply to @phoenix1647 "When my cardi first mentioned Watchman, I got on the internet and searched for all the..." + (show)

@phoenix1647

When my cardi first mentioned Watchman, I got on the internet and searched for all the information I could find. I am a person that wants to know everything I can learn about a procedure or medical condition I might have. There is a lot of info out there about the watchman.....all of it is basely the same. The official Watchman website has a lot written but does not really give that good of information. At least not what I was looking for. The official Watchman website is there for one thing only.....sell their product. I have read many write-ups from hospitals, clinics, etc about what the Watchman does and how it is supposed to work and very little about how it is put in a heart. I found ONE site that did say," if a watchman is installed, to remove it for any reason will require open heart surgery". Hmmmm...I don't recall reading that on the official Watchman website.
My first thought was "so, this thing only stops blood clots coming from LAA...I can still get a stroke from clots from other places Why bother getting the watchman." Then my cardi reminded me of how many AFIBs I was having. She said "every AFIB episode has the potential of causing a blood clot and stroke. My son and my neighbor had strokes and I saw first hand what it did to them. I do not want a stroke. If the watchman can stop just one stroke, it pays for itself. Some people will ask, how do you know if the device actually stopped a blood clot....plain simple answer is...you don't know.
Know and understand, really understand,.. the risks and possible benefits of having a Watchman procedure. There are risks with everything you do...I trust my cardi, my cardi trusts the surgeon so I will trust the surgeon knows what he is doing He has done hundreds of watchman installations. Some, like my first attempt, fail. This is not due to the surgeon, it is due to the size and location of the LAA or some other reason the surgeon feels he can not safely complete the install.

As for me, it was MY decision to get the Watchman. I decided based on all the information I could find on my own and what my cardi gave me. My cardi did NOT push me into going ahead with the procedure. She gave me the best advice she could based on my health and heart conditions. I trust my cardi and her words carried most of the weight. So, talk to your cardi. If the watchman is not right for you, your cardi should say so. If in doubt get a second opinion from an independent cardi from a hospital/clinic not related to the one your cardi is in. \

If the next attempt of installing a watchman fails, I will do the ablation route. Ablation sure was not my first choice based on my research. Again, getting this procedure should be YOUR decision. Talk to your family and friends, listen to your cardi team and do your research.

I hope this will help quell some questions and fears about the watchman.

Jump to this post

The clots that form in the left atrium lead to stroke, as the blood is pumped from the left atrium to the left ventricle through the aorta to the upper and lower part of the body. Clots that form in the veins travel to the right atrium through the pulmonary artery to the lungs to pick up oxygen. Therefore, clots in the veins can cause pulmonary embolism. Clots that cause strokes come from the artery leading from the heart.

Rainey@flora | @obag | Jan 10, 2023

Has anyone with afib had the Watchman procedure that allows you to stop taking blood thinner meds? I recently was hospitalized for internal bleeding. The source of the bleed was never found. I had 3 blood transfusions and an iron infusion. I had been taking xarelto which was stopped. Doctor is recommending I consider Watchman procedure. Is this procedure safe?

debithejedi | @debithejedi | Jan 11, 2023

In reply to @obag "Has anyone with afib had the Watchman procedure that allows you to stop taking blood thinner..." + (show)

I had the Watchman implanted 9/2021. I was able to come off Xarelto after 6 months and now on Aspirin 81mg daily. I had severe anemia requiring 4 units of packed red cells when my hemoglobin was 3.7. I spent a week in the hospital for testing (including a bone marrow biopsy) and they couldn't find where I was bleeding from. After many months and my hemoglobin dropping again I went to a
GI Dr who knew exactly what was wrong. I underwent a enteroscopy (not an endoscopy) where he found a few arteriovenous malformations in my small intestine and cauterized them. I have not had a decrease in my hemoglobin since. I have had iron infusions to resolve my iron deficiency, but no further bleeding. The Watchman was done as a safety factor regarding the history of bleeding. It was a simple procedure done under general anesthesia. I had an ablation done at the same time. I spent an overnight in the hospital and home the next morning with no lasting effects. Easy peasy!

Colleen Young, Connect Director | @colleenyoung | Jan 14, 2023

In reply to @obag "Has anyone with afib had the Watchman procedure that allows you to stop taking blood thinner..." + (show)

Welcome @obag, good questions about the Watchman implant. See this extensive discussion:
- Any experences with Watchman Implant for A-Fib? https://connect.mayoclinic.org/discussion/watchman-implant-for-a-fib/

You will read experiences about the Watchman device from many members like @kathe626 @elizabeth1941 @hopeful33250 @1943 @jimbotch @ronva2co @kidsincollege @odaleberg @phoenix1647 @fiddlinchuck and @debithejedi who can help answer your questions.

debithejedi | @debithejedi | Jan 15, 2023

In reply to @obag "Has anyone with afib had the Watchman procedure that allows you to stop taking blood thinner..." + (show)

Your story sounds like mine. I had a severe drop in my hemoglobin requiring transfusions and infusions of iron. Bleeding source finally found many months later as I researched possible causes. My Dr suggested a Watchman implant to decrease the risk of clots forming because of my history of bleeding and needing to get off blood thinners. I agreed, it was done and I only take 81mg aspirin now. Had the procedure, went home next morning and I have my last appointment with my electrophysiologist next month. They follow you for 2 years after the implant. I've never had a problem with it. You will need to carry a card with the information about the device.

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