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

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kibwezi | @kibwezi | Oct 13, 2017
In reply to @gr82balive "To me the only drawback with being on warfarin, is the monitoring INR levels, is what..." + (show)
@gr82balive

To me the only drawback with being on warfarin, is the monitoring INR levels, is what the other products advertise as being their advantage. A possible down-side to the newer products is that unlike warfarin, there isn't an antidote to reverse their effect in an emergency. I'm not sure if this is actually true, but certainly something to ask your healthcare professional about. I've been on warfarin for 5 years now without problems, other than the occasional INR being a little too low or two high depending on diet and hydration.

Jump to this post

Thank you, I had thought that I was on Xarelto because it was newer and didn't have to be monitored as closely. Didn't know there was a down side. I will have a discussion with my cardiologist about why he put me on this vs. Warfarin. I'm new to all of this.

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1 reply
gr82balive | @gr82balive | Oct 13, 2017

To me the only drawback with being on warfarin, is the monitoring INR levels, is what the other products advertise as being their advantage. A possible down-side to the newer products is that unlike warfarin, there isn't an antidote to reverse their effect in an emergency. I'm not sure if this is actually true, but certainly something to ask your healthcare professional about. I've been on warfarin for 5 years now without problems, other than the occasional INR being a little too low or two high depending on diet and hydration.

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11 replies
kibwezi | @kibwezi | Oct 13, 2017
In reply to @donaldwnelson "I've been on Warfarin for several years with no problem. I cringe when I read about..." + (show)
@donaldwnelson

I've been on Warfarin for several years with no problem. I cringe when I read about Equis and Xeralto

Jump to this post

/Why does Xarelto make you cringe. I thought Warfarin had the same cons.

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1 reply
donaldwnelson | @donaldwnelson | Oct 13, 2017

I've been on Warfarin for several years with no problem. I cringe when I read about Equis and Xeralto

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1 reply
kibwezi | @kibwezi | Oct 13, 2017
In reply to @hopeful33250 "Hello Mary, @tresjur The detailed account of your history with A-Fib was great! I'm glad that..." + (show)
@hopeful33250

Hello Mary, @tresjur

The detailed account of your history with A-Fib was great! I'm glad that you shared it with us. You gave us all a lot of insight into your thinking about this procedure. It should be very helpful to others who are considering a Watchman Device. I especially appreciate the way you recorded some of your thinking about the pros and cons. You displayed a real proactive response to your situation! Thanks,

Teresa

Jump to this post

I have been on Xarelto for about 6 weeks. I have always bruised easily and had a slow blood clotting time when I was younger. I'm beginning to get lots of new bruises. Hoping I can stay on a thinner though because like all of us I'm worried about clots.

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Tresjur | @tresjur | Oct 10, 2017
In reply to @bergordon "Hi Mary! Was very interested in reading your post. I've been on Eliquis for several years..." + (show)
@bergordon

Hi Mary!
Was very interested in reading your post. I've been on Eliquis for several years now and have had no problems until last month. On Sep 23, I developed a severe GI bleed, resulting in the loss of a lit of blood, a 5 day stay in the hospital, 2 blood transfusions and a significant setback overall. I believe my bleeding was caused from a gastric ulcer that started bleeding. Once the bleeding started, it wouldn't stop because of the Eliquis. They gave me an anticoagulant to stop the bleeding and it worked. So, I've been off of all blood thinners since then, waiting for the ulcer to heal enough for me to restart the blood thinners. I've been in and out of aFib a number of times since then, and like you, worry constantly about having a stroke. I go back to my Electrophysiologist on Monday to see where to go next. I've been researching the pros and cons of the watchman and have about decided it's my best bet. I've read where it isn't as effective as a blood thinner, but then on the other hand, it's not as dangerous either. I guess there's no one stop quick fix, we just have to go with the best option. What do you think of my thoughts? Thank you so much for sharing your experiences.

Billie

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Donald,

How long have you been on warfarin? I was on it for 14 years with no problems - switching to Pradaxa was my downfall.

Mary

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donaldwnelson | @donaldwnelson | Oct 10, 2017
In reply to @bergordon "Hi Mary! Was very interested in reading your post. I've been on Eliquis for several years..." + (show)
@bergordon

Hi Mary!
Was very interested in reading your post. I've been on Eliquis for several years now and have had no problems until last month. On Sep 23, I developed a severe GI bleed, resulting in the loss of a lit of blood, a 5 day stay in the hospital, 2 blood transfusions and a significant setback overall. I believe my bleeding was caused from a gastric ulcer that started bleeding. Once the bleeding started, it wouldn't stop because of the Eliquis. They gave me an anticoagulant to stop the bleeding and it worked. So, I've been off of all blood thinners since then, waiting for the ulcer to heal enough for me to restart the blood thinners. I've been in and out of aFib a number of times since then, and like you, worry constantly about having a stroke. I go back to my Electrophysiologist on Monday to see where to go next. I've been researching the pros and cons of the watchman and have about decided it's my best bet. I've read where it isn't as effective as a blood thinner, but then on the other hand, it's not as dangerous either. I guess there's no one stop quick fix, we just have to go with the best option. What do you think of my thoughts? Thank you so much for sharing your experiences.

Billie

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When I hear about all the problems with Pradaza and Equis I am thankful that I am still on warfarin

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Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Oct 10, 2017

Hello @yoanne

It is good to hear from you. I am glad to hear that you benefited from Mary's (@tresjur) sharing of her personal experience.

Unfortunately, we are not medical professionals and therefore cannot advise you about your particular medical situation (your own doctor would need to address these issues). Also, regarding the operation protocol, you would probably need to discuss this with your doctor. as well.

However, here is some general information about the Watchman Device from Mayo Clinic's website, https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/stroke-reduction-in-nonvalvular-atrial-fibrillation-with-the-left-atrial-appendage-closure-device-an-update/mac-20431149

As you are working through this decision process, please keep posting and let us know how you are doing. Also, if you have any particular comment or question about Mary's (@tresjur) experience please let her know!

Teresa

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yoanne | @yoanne | Oct 10, 2017
In reply to @hopeful33250 "Hello Mary, @tresjur The detailed account of your history with A-Fib was great! I'm glad that..." + (show)
@hopeful33250

Hello Mary, @tresjur

The detailed account of your history with A-Fib was great! I'm glad that you shared it with us. You gave us all a lot of insight into your thinking about this procedure. It should be very helpful to others who are considering a Watchman Device. I especially appreciate the way you recorded some of your thinking about the pros and cons. You displayed a real proactive response to your situation! Thanks,

Teresa

Jump to this post

@tresjur
hello Mary and Teresa. as I mentioned some time ago, I had a surgical ablation together with a mitral valve repair. until now I'm doing very well, no A-Fib .anymore as far as I can feel. I'm still on Eliquis at a lower dose, to prevent bleedings like I had on Xarelto. the dose reduction was possible, because of my low weight (50 kg).
a couple of weeks ago I went to the heart center of cologne/germany. ,where I got the newest results of their investigations.in particular I was interested to read about the actual recommendations as to the surgical options for the treatment of A-Fib. They referred to the american society of thoracic surgeons 2017 :
The Society of Thoracic Surgeons 2017 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation (
http://www.annalsthoracicsurgery.org/article/S0003-4975(16)31615-0/abstract
I understood that no further anticoagulation is necessary wenn an echocardiogram before discontinuing anticoagulation shows adequate LA emptying by the absence of spontaneous LA echocardiography contrast .on the other hand they recommend the implantation of a watchman device (never heard of that name before!! ) if possible!!. I intend to discuss these new findings/recommendations with my cardiologist next month. also I like to have a copy of the operation protocol, maybe they implanted such a device (if not why didn't they do it, ? maybe repair of the mitral valve + ablation + watchman would be too risky for me?
I hope these informations are helpful for you.
yoanne

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Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Oct 8, 2017

Hello Mary, @tresjur

The detailed account of your history with A-Fib was great! I'm glad that you shared it with us. You gave us all a lot of insight into your thinking about this procedure. It should be very helpful to others who are considering a Watchman Device. I especially appreciate the way you recorded some of your thinking about the pros and cons. You displayed a real proactive response to your situation! Thanks,

Teresa

REPLY
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