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

@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.

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GOOD MORNING!
I AM A BIT CONFUSED. YOU ARE TAKING ASPRIN AND BLOOD THINNERS? ARE YOU TAKING AN ADULT OR BABY ASPRIN?
I AM ALL FOR BEING OUR OWN ADVOCATE, BUT IF YOU ARE NOT PLEASED WITH THE WAY YOUR DOC IS CARING FOR YOUR AFIB, WHY NOT FIND ONE YOU LIKE? IF YOU REMAIN WITH THIS DOC, IT IS IMPORTANT THAT HE/SHE KNOWS YOU ARE TAKING ASPRIN SINCE IT MIGHT HAVE AN IMPACT ON THE MEDS YOU ARE GIVEN AND THE WAY YOUR TREATMENT PLAN WILL GO.
IF YOU FEAR FOR YOUR SAFETY, WHY NOT GET ONE OF THOSE 'I CAN'T GET UP' EMERGENCY NECKLACE? I HAVE ONE AND WEAR IT WHEN I AM ALONE IN MY HOUSE. I AM 63 BUT I AM AT RISK TO FALL. I CERTAINLY FEEL SAFER WITH IT.

HAVE A GREAT DAY!
Ronnie (GRANDMAr)

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@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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Hello Billie,

I'm so sorry to have taken so long to write. Somewhere I missed your post so I did not know where you were in getting the implant. I'm so glad to hear that you finally had it done and all is going well for you. From your description, your procedural plan is actually what I experienced. Yesterday I had my final 6 month checkup and as of today, I am on the low dose aspirin only. My journey went well, I had no problems after the implantation and I have no complaints to date. It is a relief to be able to drop one med (Plavix) from my daily regime.

Take care and please keep in touch.

Blessings,
Mary

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@1943

Recently had the watchman installed. Have to go back in six weeks for echo?

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Hello @1943

It was good to hear from you and know about your Watchman procedure. We have a discussion on Connect regarding that and I would like to ask our moderator, @lisalucier, to move your post to that discussion group, so you can meet others who have discussed this implant. https://connect.mayoclinic.org/discussion/watchman-implant-for-a-fib/?pg=1#comment-75936.

In the meantime, I would like to invite Mary, @tresjur, to join you in discussing this as well as @bergordon. They have both discussed this procedure in the past.

Did you have the Watchman procedure because of A-Fib? Had other treatments been tried first? I hope you are doing well. Continue to post as you feel comfortable doing so. I would enjoy hearing from you again.

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Recently had the watchman installed. Have to go back in six weeks for echo?

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@hopeful33250

Hello @1943

It was good to hear from you and know about your Watchman procedure. We have a discussion on Connect regarding that and I would like to ask our moderator, @lisalucier, to move your post to that discussion group, so you can meet others who have discussed this implant. https://connect.mayoclinic.org/discussion/watchman-implant-for-a-fib/?pg=1#comment-75936.

In the meantime, I would like to invite Mary, @tresjur, to join you in discussing this as well as @bergordon. They have both discussed this procedure in the past.

Did you have the Watchman procedure because of A-Fib? Had other treatments been tried first? I hope you are doing well. Continue to post as you feel comfortable doing so. I would enjoy hearing from you again.

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Had the watchman installed because of 2major bleeds while on eliquis.was on eliquis because of afib. First bleed was gastro , second was hematoma of the brain

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@1943

Had the watchman installed because of 2major bleeds while on eliquis.was on eliquis because of afib. First bleed was gastro , second was hematoma of the brain

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I am sorry to hear about such serious bleeds, @1943. How long was your recovery from the brain bleed?

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I was just in the hosp a few days for observation and then close follow up with several cat scans. Also very close follow up with a neurosurgeon. It has been 4 months and I was without a blood thinner it was just recently decided the watchman was the procedure that was needed I am on eliqui s again for a short time but should not need abloo d thinner when heart heals over the watchman .

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@tresjur

Today I reached the one-month mark since I had the Watchman implanted. My first follow-up appointment with the electrophysiologist is on the 17th and I pray all is okay. I’m feeling well but look forward to getting off the Eliquis as it does scare me that there is no reversal in case of bleeding. The next step is another TEE (on Oct. 30) to look at the implant from the esophagus.

Will keep you updated as I progress.

Mary

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Heard there is now an antidote for eliquis. Was approved in may.

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@tresjur

Today I reached the one-month mark since I had the Watchman implanted. My first follow-up appointment with the electrophysiologist is on the 17th and I pray all is okay. I’m feeling well but look forward to getting off the Eliquis as it does scare me that there is no reversal in case of bleeding. The next step is another TEE (on Oct. 30) to look at the implant from the esophagus.

Will keep you updated as I progress.

Mary

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I think there is a reversal drug for eliquis now. It was approved inmay.

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@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.

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For those on Warfarin who find monitoring INR levels a pain, I used to. It involved a drive to a local lab, being poked in my only good vein and a drive home. I didn't know for a few years that there is a home monitor that only requires a finger stick (a little more blood than a blood sugar poke). I've been doing that for a few years now. It's been really helpful when I am put on an antibiotic or other drug that may interfere with the INR. I can do extra tests as directed by my cardiologist without the hassle. I've found it to be pretty accurate and certainly easy to use. Results are entered online or by phone.

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@iowafemale

For those on Warfarin who find monitoring INR levels a pain, I used to. It involved a drive to a local lab, being poked in my only good vein and a drive home. I didn't know for a few years that there is a home monitor that only requires a finger stick (a little more blood than a blood sugar poke). I've been doing that for a few years now. It's been really helpful when I am put on an antibiotic or other drug that may interfere with the INR. I can do extra tests as directed by my cardiologist without the hassle. I've found it to be pretty accurate and certainly easy to use. Results are entered online or by phone.

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@iowafemale

Welcome to Connect, I see that this is your first post.

Thanks for sharing that information, it sounds like a very convenient way to keep track of the INR levels.

Did you need a doctor's prescription in order to obtain this device? Are the test strips involved, like a diabetic testing kit?

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@hopeful33250

@iowafemale

Welcome to Connect, I see that this is your first post.

Thanks for sharing that information, it sounds like a very convenient way to keep track of the INR levels.

Did you need a doctor's prescription in order to obtain this device? Are the test strips involved, like a diabetic testing kit?

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Yes, just a doctor's prescription. And there are test strips that are shipped to you by Roche.

My first post. Just joined Connect although I have been a Mayo patient for ten years, since a-fib was diagnosed. I've had two ablations (Dr. Munger is awesome!). The second one three years ago with no recurrence (yet).

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@iowafemale

Yes, just a doctor's prescription. And there are test strips that are shipped to you by Roche.

My first post. Just joined Connect although I have been a Mayo patient for ten years, since a-fib was diagnosed. I've had two ablations (Dr. Munger is awesome!). The second one three years ago with no recurrence (yet).

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@iowafemale
I'm glad to hear that you are doing so well! Thanks for all of the interesting information about home testing for INR levels.

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@1943

I was just in the hosp a few days for observation and then close follow up with several cat scans. Also very close follow up with a neurosurgeon. It has been 4 months and I was without a blood thinner it was just recently decided the watchman was the procedure that was needed I am on eliqui s again for a short time but should not need abloo d thinner when heart heals over the watchman .

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Dear 1943,

I've just passed 13 months since I had the Watchman installed and I have been doing great. I had gone 3 years without any treatment for the A-Fib and at the same time living with the fear of a possible stroke. I cannot vouch for the long-term, but for now, having the Watchman has taken the stroke worry off my plate. I had no problem with the Eliquis when I was on it and I now take the low dose aspirin daily. I pray that the Watchman implant was the right treatment for you as it has been for me.

Mary

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So had to hear you are doing well after the watchman procedure. It is so good to know there is something out there for those of us that can't take blood thinners.

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