According to the Centers for Disease Control and Prevention, approximately 700,000 Americans are hospitalized annually with atrial fibrillation as their primary diagnosis. Without intervention, these patients become five times more likely to experience debilitating and deadly ischemic strokes, which are caused by blockage of blood flow.
Atrial fibrillation occurs when the upper and lower chambers of the heart are regulated properly because the electrical impulses governing heart activity have malfunctioned. Beating too quickly, too slowly or irregularly produces disunity among the chambers. Blood is not fully emptied from the heart, and lingering blood cells can pool together and clot. If a clot escapes to the brain, it can block blood flow, causing a stroke.
Unfortunately, 30% of nonvalvular atrial fibrillation patients struggle tolerating the prescribed blood thinners. However, thanks to a relatively new and minimally invasive surgery known as the WATCHMAN implant procedure, at-risk patients have an alternative course of action. Backed by a decade of clinical studies and trials, and with FDA approval since 2015, the WATCHMAN device has proven itself to be a safe and effective procedure with minimal recovery time.
Chetan Patel, M.D., an interventional cardiologist with Prisma Health, said, “Today, WATCHMAN is available at many hospitals, and more than 100,000 of these implants have been done across the country. Greenville Memorial Hospital was the first health care facility to offer it in Greenville.”
Prisma Health-affiliated hospitals have performed approximately 450 WATCHMAN procedures since 2017.
When a newer WATCHMAN FLX device received FDA approval last month, once again, Prisma Health became one of the first health care systems in the Carolinas to begin using it. The improved version is considered safer, easier and more efficient. It also is manufactured in a wider variety of sizes, making it available for a broader group of patients. Like its predecessor, the new device offers relief to those who cannot tolerate the side effects of blood-thinning medications. Currently, Greenville Memorial is the only hospital in the Greenville County area to have transitioned to WATCHMAN FLX.
To perform the WATCHMAN procedure, Dr. Patel inserts a tiny, malleable metal device up the main vein of the groin, similar to a heart catheterization or ablation procedure. The device is placed in the left atrial appendage, the location from which more than 90% of clots are formed in nonvalvular atrial fibrillation patients. With time, the heart cells encase the device in tissue, effectively closing the area to future clot dispersion. This one-time procedure has significantly reduced the risk of stroke.
At Greenville Memorial Hospital, the typical WATCHMAN implant surgery averages less than an hour under general anesthesia. After approximately four additional hours of bed rest, patients are up and walking, kept overnight for observation and released the following day with minimal discomfort. They are asked to avoid heavy lifting or exertion for a week and then are fully recovered. Rejection rates are rare enough to be considered insignificant.
If there is one physical health challenge that most seniors truly dread, it is the prospect of having an unexpected stroke. Mental pictures of someone struggling to drag a lifeless foot across the floor, awkwardly cradling the weight of a useless arm and speaking in halting, sometimes barely distinguishable words is the stuff of elderly nightmares. Dr. Patel, who is with Prisma Health’s Carolina Cardiology Consultants-Greenville, is keenly aware that when he performs the WATCHMAN procedure, he is not only improving his patients’ health and quality of life but also giving them hope that they will be able to enjoy their later years.
When asked how he feels about his work, simply responded, “I know that by offering the WATCHMAN therapy, I can potentially improve my patients’ quality of life as well as help decrease one of their biggest fears.”
Ideal candidates for the WATCHMAN procedure have atrial fibrillation not caused by a heart-valve problem, are at high risk of stroke and have not been able to tolerate blood thinners well. Active atrial fibrillation patients may also wish to switch because they fear the increased risk of falling or being injured while taking blood thinners.
The WATCHMAN procedure offers the opportunity both for better health and peace of mind.
By Janet E. Perrigo