Watchman: A Stroke-Risk Reduction Alternative for A Fib Patients

There is now a non-pharmacological alternative to anticoagulation for selected A Fib patients.

Atrial fibrillation (A Fib) causes 15 – 20% of ischemic strokes, and over 90% of clots causing strokes in A Fib are formed in the left atrial appendage (LAA). The Watchman closure device occludes the LAA, eliminating the risk of clots dislodging and causing a stroke.

A lightweight, parachuteshaped device, the Watchman is inserted by catheter through the patient’s blood vessel via the groin. Typically, after 45 days of deploying the Watchman, patients can be taken off blood thinners – eliminating their worries about falling, bleeding or hurting themselves.

While it is an invasive therapy, North Memorial Health Heart & Vascular Center – Robbinsdale is seeing excellent outcomes. Patients who will benefit from the Watchman are selected carefully—see sidebar about ideal candidates.

Watchman has a proven safety record with over a 95% procedural success rate and a low 1.5% complication rate. At five years, Watchman has a 55% lower relative risk of disabling or fatal strokes compared to treatment with warfarin.

Watchman has shown SIGNIFICANT REDUCTIONS in the risk of stroke in non-valvular atrial fibrillation patients WITHOUT THE BLEEDING RISKS that come with a lifetime of anticoagulant use.

Watchman is not a universal alternative to anticoagulants. Currently, it is approved for non-valvular A Fib patients who are not ideal candidates for long-term blood thinners due to:

• Major bleeding
• Frequent falling or high fall risk (frailty, disability, balance issues)
• Occupation, medical condition or lifestyle that is a high risk for major bleeding
• Development of severe kidney disease
• Inability to maintain INRs within an adequate range