Any experiences with Watchman Implant for A-Fib?

Why bother to render an opinion when we have data from two studies (the "PROTECT" & "PREVAIL" studies) & a rigorous assessment of LAAO & implantation of the Watchman from one of America's preeminent electrophysiologists (cardiologist & clinical researcher), John Mandrola, M.D.?

Quoting the major points against LAAO & implantation of the Watchman--& the URL to Dr. Mandrola's review (in his role as the cardiology editor for Medscape) in his Medscape article: See: https://johnmandrola.substack.com/p/the-case-against-watchman-for-stroke:

"Six major points form the case against this procedure:

* Data from the two pivotal regulatory trials (Watchman vs Warfarin) do not convince me. There were higher rates of ischemic stroke in the Watchman arm.

* PROTECT and PREVAIL (studies of LAAO & the implantation of the Watchman) found no difference in major bleeding (if you count bleeding surrounding the procedure).

* Percutaneous closure requires anti-platelet therapy and at least two studies find bleeding rates on anti-platelets are not much different from anticoagulants.

* A foreign body in the heart can act as a nidus for clot formation. Device-related thrombus has been reported—and can occur many months after implant.

* The procedure to implant this device has a major complication rate ranging from 3-9%. So even if there were future benefits (there aren’t), patients start the gamble with a significant upfront risk of harm.

* There is dubious pathophysiological basis for this procedure. Recall that stroke is a systemic disease and LAA appendage closure is a focal solution."

Mary, I had a Watchman implant nearly 2 years ago in December 2021. The procedure was straight forward and did involve 1 night in the hospital. The worst part for me was the need to lie still on my back for 6 hours after the procedure while the entry point in my groin closed and began clotting. Followup TEE’s have showed the Watchman to be in place and functioning as planned. To me, it has been invisible as I have no sensation that it is there. I do take a daily 325 mg aspirin, as directed, and have handled that as well. Having the Watchman gives me peace of mind about not having blood clots and an associated stroke. While I am not immune from blood clots forming and traveling to my brain, the risk of this happening has been reduced by having the Watchman. Before my procedure, I shared your concerns about having something inserted into my heart. I suggest reading as much as you can about it. Also, I found an animation of the procedure somewhere on line that helped me visualize exactly what was going to be done, which was helpful to me. Having been through it now, I feel that it was a safe, mostly painless procedure that yields great benefits and I would not hesitate to encourage you to go forward with it, if that is your wish. Best of luck to you!

Thank you for the information. I have been wrestling with this decision for about 5 months. My afib was controlled well with Flecainide and Eliquis as my blood thinner for 4 years but I had an episode of gastrointestinal bleeding early this year requiring a blood transfusion. I just had my 2nd opinion by an electrophysiologist from Cleveland Clinic. It looks like the procedure is in my future but it's nice to hear firsthand from someone who has been through it. I appreciate your sharing this. I still get anxious when I think about inserting something within my heart though.

The device is approximately 1/8” x 1” x 2” and sends a signal anytime I have an AFib beat. Used to verify need for watchman. He is now scheduling an ultrasound for my abdomin and is changing me at my request from $545 eliquis to $24 warfarin. I am concerned that additional tests are unnecessary since all other tests, except the Holder monitor have been normal.

@fredster4

Perhaps someone else in the group is familiar with this device. You might want to contact the office, either through the patient portal or by phone to get some more information.

He did not name it but indicated it goes into a small pocket in the chest and is used to determine if watchman is correct for me. I would think the previous week long Holder (?) monitor would do that. Test it again now that I am on eliquis?

Hello @fred03

I appreciate you keeping in touch.

What type of device is the cardiologist recommending prior to implanting the Watchman?

The best word to describe my feeling is weird. Have developed strange aches and pains which my cardiologist says are not related. Some bruising. All tests are normal except for a very few AFib times. He wants to implant a device for further analysis before recommending the watchman. I am on Eliquis, plus Amiodarone was added on day two.

How refreshing: A frank & honest cardiologist!

I had an ablation for A-fib and my EP told me I’d be taking Eliquis for life.
He also told me that having an ablation is not a cure for A-fib and an episode could happen again hence the need for Eliquis.

I pay $30/month for Eliquis and my insurance picks up the rest.

MaryB