Watchman devise

I had the Watchman surgery in Aug 2024 & have done well. I was 77 years old at the time & had very little recovery time, a little tired for a few days. It was an outpatient procedure for me. I had an ablation the month before. I’ve had no a-fib since then & am off the blood thinner. It’s been a blessing! Hope my experience gives you peace about the decision!

I recently discussed my options about the Watchman with an EP. He said I must be taking Eliquis 5 mg/ 2x a day or the equivalent of another DOAC or. blood thinner in order to be eligible. That's not an option for me, as my body is reacting with a lot of muscle weakness to even a much lower dose. I am currently taking Eliquis 2.5 mg/ once a day, and I am considering getting off it entirely, perhaps trying Warfarin. I am also wary of the Trans-Esophageal Echocardiograms that are part of the watchman procedure. Typically they do it 3 -4 times within 6 months and or more, and I would require full sedation for this. That's a lot of drugs for me.

@devotion Before you make the switch from Eliquis to Warfarin. Do some research on Warfarin. With Warfarin there are many foods that need to be limited and you also need INR checked every 2 weeks. Researching this will help you make a wise decision.

@devotion There is absolutely no need to do a confirmatory TEE more than once. Who told you it's 3-4 times? If it was an EP, find another....pronto. Run, don't walk.

I do agree that the installation of a Watchman imparts a risk of clotting and stroke all by itself. So, there might be an empirical argument for a DOAC to be taken when a Watchman is installed, although I have not gone looking or seen it. I can understand the reasoning, though. But the DOAC is meant to reduce the chances of a clot WHILE the LAA is either open or being sealed because clots can issue from the LAA for literally months after the last bout of AF. The usual protocol is to do a confirmatory TEE at about the six month mark, and some EPs might want a second another six months later if the first was 'inconclusive' or worrying. So, that's at most two, and again, not all EPs want the second. If the TEE shows no leakage, you almost certainly CAN go off the DOAC......provided.....there are no other/new reasons to stay on it. So, if you have another comorbidity, it might be wiser to stay on a DOAC. But if you're otherwise good, and the TEE shows you're not leaking, then most EPs will agree to let you go off a DOAC, maybe though to take a baby aspirin instead.

I have been on a couple of sites dealing with AF and its treatment for several years now, and I have seen all sorts of protocols described and prescribed. It depends on the EP, on the patient and what else is going on inside them, but I have never seen an anecdote where the poster says they've had more than two TEEs.

Perhaps I have misunderstood or missed something about your case. Is there more you can share publicly and willingly? I hope I haven't offended....

I had an ablation and watchman completed 4 months and doing great! I'm 76.

@rainyday541

Hello: As suggested, please do research Warfarin vs. Eliquis. You are wise to choose Eliquis. Warfarin does not give you the protection for DVTs and PEs as Eliquis does. (my experience only.) Eliquis broke up a DVT after total knee replacement (had been on Warfarin for many years prior). Warfarin was resumed 2 days after TKR , but I developed a DVT. I was completely immobile for 30 days because of that, and my doctors felt the clot was broken after 30 days. After staying on Warfarin for next 7 months, I had to have the knee adhesions and scar tissue released that resulted from no PT immediately after TKR. But, before I agreed to this next surgery, I asked to be put on Eliquis and then of course, stop as instructed by surgeon before surgery date. I had only been on Eliquis for only 2 days, when my husband found me passed out, non responsive and had ambulance ride to hospital. THAT DVT initially had JUST gotten released and it had traveled to my lungs causing a PE. Eliquis was my life saver!!! I was thankful for hospital staff in getting the PE dissolved before a massive stroke or death. I've been on Eliquis 5mgx2 daily now for 8 years and would never go back to Warfarin. Blood thinners are life savers; however, some do not give you the protection as others. (Warfarin does not!!) Please do your research and may you make the right decision for your health. This is just my personal experience with taking both; others have their own experiences and I respect everyone's decision. I wish you well.

@christi831 Agreed, and aspirin is also not the right treatment for some risks of thromboembolic events. They all carry risks, some are tolerated better than others, but they all work on different clotting mechanisms.