Device is Alternative to Blood Thinner for Stroke Prevention
A new device that prevents the formation of stroke-causing blood clots in people with atrial fibrillation is now available at Wake Forest Baptist Medical Center.
This recently approved technology – a left atrial appendage (LAA) closure device called the Watchman that is implanted in a section of the heart – offers an alternative to the blood thinner warfarin as a long-term stroke-prevention therapy.
Wake Forest Baptist is the only hospital in the Piedmont Triad region and one of just 65 in the country to offer this minimally invasive procedure, which in clinical trials has been shown to reduce stroke risk by 77 percent.
Atrial fibrillation, or AFib, is an irregular and frequently rapid heartbeat. While generally not life-threatening in itself, AFib does have some serious complications, among them the formation of blood clots in the heart that can circulate through the body and block the flow of blood to other organs. A stroke occurs when blood flow to the brain is interrupted.
Warfarin, an anticoagulant widely dispensed under the trade name Coumadin, is the most commonly prescribed long-term stroke-prevention therapy for people with non-valvular AFib. But the medication has a number of drawbacks, including increased risk of serious bleeding, negative interaction with numerous prescription and over-the-counter medicines, and some dietary restrictions.
Instead of thinning the blood to prevent clots from forming, the Watchman closes off the LAA, a small pouch in the upper left chamber of the heart. Research indicates that around 20 percent of all ischemic (clot-related) strokes happen in people with AFib and that 90 percent of these can be traced to clots originating in the LAA.
In a procedure that takes about an hour, the Watchman device, which is approximately the size of a quarter, is inserted into the heart via a catheter placed in a vein in the upper leg. Once in place, the device opens like an umbrella to plug the LAA. Heart tissue grows over the implant in about six weeks, creating a permanent barrier to blood clot formation.
Patients typically spend one night in the hospital, and most are able to stop taking warfarin within 45 days.
David Zhao, M.D., director of Wake Forest Baptist’s Heart and Vascular Center, and S. Patrick Whalen, M.D., director of cardiac electrophysiology, have implanted nine of the devices to date, with excellent results.
“This procedure provides patients an alternative to taking medications long-term to control their AFib,” Whalen said. “For patients whose AFib is not well controlled and those who can’t take blood thinners, this is a significant step in helping them have a better quality of life.”
The Watchman device is manufactured by Boston Scientific Corp.
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