Over the last 10 years, incredible advancements in catheter-based technology have helped patients receive less invasive treatments for serious heart conditions. These conditions previously could only be treated with open heart surgery.
The structural heart team at Intermountain Medical Center is at the forefront of these discoveries and is excited to offer a catheter-based procedure to reduce the risk of stroke in patients with atrial fibrillation. This is especially important for patients who have trouble taking blood thinners.
Atrial fibrillation (AFib) is a heart rhythm abnormality that affects many people, especially those over the age of 65. An estimated 3 to 6 million people in the United States have AFib. That number is only expected to increase as the U.S. population ages. During episodes of AFib, chaotic electrical signals in the upper heart chambers (atria) overwhelm the pacemaker of the heart, causing the atria to quiver and the lower heart chambers (ventricles) to beat fast and irregular. Not all patients with AFib experience symptoms, but many people develop:
- heart palpitations
- shortness of breath
- chest pain
It’s important to identify people with AFib, whether or not they develop symptoms. If left untreated, AFib puts patients at a higher risk for stroke. According to the National Institutes of Health, the average person with AFib is five times more likely to suffer a stroke than someone with a normal heart rhythm, and approximately 1 in 4 strokes are a result of AFib. During a bout of AFib, blood can stagnate and form clots, which can then travel to the brain and cut off blood supply causing a serious stroke.
Different treatments are available to reduce stroke. The most common approach is with medications that prevent blood clots. These medications, often called anti-coagulants or blood thinners, work well for many people. But AFib is a lifelong problem, and not everyone can take blood thinners long term. Some patients experience bleeding complications on blood thinners, and others may be at risk of falling, which could cause traumatic bleeding. If these individuals stopped taking blood thinners, they would live with an increased risk of stroke.
A newly developed device, the WATCHMAN™, can reduce the risk of stroke in patients who are unable to take long-term blood thinners. The WATCHMAN™ is an FDA-approved implant that fits into a part of the left atrium called the left atrial appendage. Ninety percent of blood clots form in the left atrial appendage. The WATCHMAN™ is designed to close the left atrial appendage and keep clots from escaping. This is a one-time procedure where a physician makes a small puncture in the leg, inserts a catheter, and implants the device in the left atrium. This procedure is done under general anesthesia and takes approximately one hour.
Results from several clinical trials show the WATCHMAN™ has a similar reduction in stroke compared to blood thinners – ie; COUMADIN (warfarin sodium). Doctors at Intermountain Medical Center have been treating patients with WATCHMAN™ since the early clinical trials, and have implanted more than 300 devices.
Kline Bradford, a recent patient, received a WATCHMAN™. He was on blood thinners to reduce his risk of stroke from AFib. Bradford was “enthusiastic” to get off blood thinners due to recurrent nosebleeds that would interrupt him at work and home. He also was involved in a car accident and, because of the blood thinners, had severe bruising that lasted for months. “The WATCHMAN™ procedure went very smoothly and afterward I felt fine. I was up and walking within a few hours of the procedure,” Bradford said. “For me I felt like it was a tremendous blessing. I am very active. I like to cycle and ski and a lot of different things. Thanks to the WATCHMAN™, I got off the blood thinners, and am able to do more of those things again.”
The field of structural cardiology continues to advance at a dizzying pace. New emerging technologies allow us to offer treatments to patients with heart conditions. The WATCHMAN™ is an excellent example of research and clinical practice combining to help our patients live the healthiest lives possible.