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Watchman Heart Device Traps Blood Clots Reduces Risk of Stroke

The Watchman device reduces the risk of stroke in people with the heart rhythm disorder atrial fibrillation. Cardiologist Heath Saltzman, MD, explains how it works.

Updated August 04, 2022

By Heath Saltzman, MD, FACC, FHRS, FACP, Cardiologist, Virtua Heart Rhythm Specialists

Atrial fibrillation (AFib) can feel like your heart is about to fly out of your chest. While you’ll remain earthbound, this common type of irregular heart rhythm can cause blood clots to form, heightening your chances of having a stroke.

People with AFib often take a blood thinner to reduce the risk of stroke. But if you have AFib not related to a heart valve problem and can’t take long-term blood thinners due to bleeding concerns, the Watchman, a parachute-shaped device the size of a quarter implanted within your heart, could be your answer.

The Watchman device closes off the left atrial appendage, the area in the heart where blood clots most commonly form and can travel to the brain, causing a stroke.

Faulty Signals
The heart’s electrical system sends signals telling the upper chambers (atria) and lower chambers (ventricles) when to squeeze and pump blood to the body. With AFib, the signal is chaotic, causing the atria to quiver, or fibrillate, rather than beat regularly.

As the atria and ventricles are no longer in sync, and the atria are not squeezing in an organized fashion, blood is able to pool, especially in the left atrial appendage.

Blood that pools tends to stick together and clot. More than 90 percent of blood clots related to AFib tend to form in this small part of the left atrium.

Barrier Against Clots
To implant the device, the doctor threads a catheter through a vein in your upper leg to your heart. A tiny hole made through the wall between the atria allows the catheter to reach the appendage.

The Watchman is placed in the entrance of the appendage. Patients usually spend one night in the hospital before going home.

Within about a month, a layer of tissue grows over the device, securing it in place. The hole between the atria heals quickly as well.

Once the appendage is sealed off, any clots that may form are trapped inside. You don't have to worry about them getting out and traveling through the bloodstream.

Reduced Need for Blood Thinners
As you recover, you will take a blood thinner for 45 days, and then aspirin and clopidogrel (Plavix) for six months. After that, only a daily aspirin is needed.

As people with AFib can have as high as a 30 to 40% risk of stroke over a five-year period, this device can greatly change lives. If you have AFib, talk to your cardiologist to see if you are a candidate.

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