Any experiences with Watchman Implant for A-Fib?
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.
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
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
Welcome to the Heart & Blood Health group, @tresjur,
Thank you so much for sharing your story; I'm certain that many Connect members will appreciate your insights.
I encourage you to view this discussion, "AFib questions" https://connect.mayoclinic.org/discussion/good-morning-im-almost-66-years-old-with-infrequent-afib-and-on/ where you'll meet @frank4848 @cynaburst @predictable @patinhou @martishka @carnes @twptrustrek and others who have written about Afib, and alternatives to blood thinners.
I'd also like to introduce you to @liberty @tazio and @yoanne who've posted questions about the risks associated with blood thinners, and I hope they will join this discussion with their thoughts.
Here's a clinical update from Mayo Clinic, which compares other procedures and devices like the Watchman: http://www.mayoclinic.org/medical-professionals/clinical-updates/cardiovascular/stroke-reduction-utilizing-left-atrial-appendage-exclusion
You may also wish to learn more about this open clinical trial/study at Mayo Clinic
– Assessment of the WATCHMAN™ Device in Patients Unsuitable for Oral Anticoagulation http://www.mayo.edu/research/clinical-trials/cls-20313922?_ga=2.226878683.790434124.1505482537-2033052444.1499398509
In the meantime, we look forward to getting to know you, @tresjur. Are their certain foods you have to avoid now? Do you have suggestions or tips for Connect members who may be considering this procedure?