The Watchman™ Left Arial Appendage Closure Device offers select patients with atrial fibrillation an alternative to warfarin to prevent a potentially life-threatening stroke.
More than 5 million Americans have atrial fibrillation (AFib), the most common type of heart arrhythmia. This population is at an increased risk of stroke—in fact, one in three AFib patients is likely to have a stroke. To reduce this risk, AFib patients may need a blood-thinning medication such as warfarin or other anticoagulant. However, some patients who need blood thinners may not be able to take them because of a high risk of bleeding, which is when the Watchman Device may be an alternative.
The University of Michigan Frankel Cardiovascular Center is among the first heart centers in the nation to use the Watchman device to help prevent stroke among patients whose atrial fibrillation is not caused by heart valve problems.
How the Watchman Device Works
The lightweight, umbrella- or parachute-shaped Watchman device is inserted by catheter through a recipient’s blood vessel accessed through the groin. It is designed to seal off the heart’s left atrial appendage (LAA), a sack-like pouch within one of the organ’s two upper chamber. For patients with AFib over 90 percent of stroke causing clots that develop in the heart are formed in the LAA. A person’s heart tissue will grow over the permanent implant in time. The device is available in several sizes to best fit a recipient’s body.
Who’s Eligible for the Watchman Device?
The Watchman isn’t meant to be a universal alternative to anticoagulants, with only carefully chosen patients eligible for it.
The Watchman is for patients who:
- Have atrial fibrillation not caused by heart valve problems.
- Have been recommended to take blood thinning medicines by their doctor.
- Can take warfarin but need an alternative to blood thinners because they have a history of bleeding or a lifestyle that puts them at risk for bleeding.
Patients who should not receive the implant include, but are not limited to, patients who:
- Cannot take warfarin, aspirin or clopidogrel.
- Should not or cannot undergo heart catheterization procedures.
- Have an allergy or sensitivity to nitinol (nickel and titanium) or any of the other materials in the Watchman device.
- Have a left atrial appendage that is too large or too small to fit the Watchman device.
For these patients, other options designed to prevent blood clots from forming in the heart’s left atrial appendage include:
- LARIAT Device: During this catheter-based procedure a device known as LARIAT is placed at the base of the left atrial appendage to seal off the area from the rest of the heart.
- AtriClip: During this minimally invasive procedure the AtriClip device is applied to the outside surface of the left atrial appendage, permanently closing it at its base.
What to Expect Before and After Watchman
A potential recipient will undergo a transesophageal echocardiogram (TEE) to ensure no existing clots are present and to determine whether the appendage is compatible with one of the available device sizes and shapes. Clots, if detected, will need to be treated with blood thinners before proceeding.
Approximately the size of a quarter, the Watchman device is implanted like a stent using a narrow tube or catheter inserted through a small incision in the upper leg and guided into the heart while the patient is under general anesthesia. The minimally invasive procedure typically takes no more than one hour and involves only an overnight hospital stay. Patients should be able to return to normal activities shortly after the procedure.
Extended follow-up, however, is involved. A recipient can expect subsequent TEEs at 45 days and 12 months after surgery to ensure that the Watchman is working properly and the left atrial appendage remains closed.
Patients also need to continue a warfarin regimen for 45 days.
The Watchman device has a proven record of safety, with more than 20,000 procedures performed worldwide and over 10 years of clinical studies in some 2,000 patients. It is the only device of its kind approved by the U.S. Food and Drug Administration.
Patient Resources and More Information
- Michigan Health Blog Post: Watchman vs. Blood Thinners: Alternatives for Patients with Nonvalvular Atrial Fibrillation
- Watchman Patient Information Brochure from Boston Scientific
- Video Animation: "How Watchman Works" on watchman.com
Make an Appointment
To schedule an appointment to discuss your heart arrhythmia or other cardiovascular condition, call us at 888-287-1082. Visit our Make an Appointment page for more information about what to expect when you call us.