People with atrial fibrillation now have a new alternative to blood-thinning medication to reduce the risk of stroke — a life-threatening complication of the heart condition.
Cardiologists with PeaceHealth Southwest Medical Center and The Vancouver Clinic are among the first in the region to offer a new device aimed at preventing blood clots that can cause strokes without the use of warfarin or other blood thinners. The device, called a Watchman Left Atrial Appendage Closure implant, was approved by the Food and Drug Administration in March.
PeaceHealth Southwest will be the first site to use the device between Sacramento, Calif., and Seattle, according to PeaceHealth officials. The first local procedure is scheduled for Oct. 29.
“This is a big step because anticoagulants aren’t for everyone,” said Dr. Ben John, a clinical cardiac electrophysiologist at The Vancouver Clinic.
Atrial fibrillation, or AFib, is an irregular and often rapid heart rate. During atrial fibrillation, the heart’s two upper chambers beat chaotically and irregularly, out of coordination with the lower two chambers of the heart, according to Mayo Clinic.
Patients with atrial fibrillation are at risk of stroke because of a small pouch — the left atrial appendage — on the heart. The pouch, which is in the left upper chamber of the heart, doesn’t serve any significant purpose, said Dr. Jonathan Lowy, a clinical cardiac electrophysiologist at PeaceHealth Southwest.
“We think of it as the appendix of the heart,” he said. “It just causes problems.”
Typically, that pouch pulses normally as the heart pumps. But when the heart is in atrial fibrillation, the pouch quivers, Lowy said. That allows blood to pool up in the pouch and form clots. If those clots break free, they can travel to the brain and cause a stroke, he said.
To prevent those clots from forming, many AFib patients who are at risk of stroke receive blood-thinning medication. The problem, Lowy said, is that the medication comes with its own risk: bleeding throughout the body, which could cause another type of stroke.
The new Watchman device gives cardiologists another option.
“We can go up and essentially seal off that pouch,” Lowy said.
Cardiologists insert a catheter through a vein in the leg. The catheter travels through the vein, through the right upper chamber and into the left upper chamber of the heart. Once there, the implant opens like a parachute and is placed at the opening of the pouch, Lowy said.
The patient must continue to take the blood thinners for 45 days after the procedure, in which time a thin layer of tissue grows over the implant and seals the opening. After that, more than 90 percent of people in clinical studies were able to stop taking blood-thinning medication.
“Nobody likes being on blood thinners,” Lowy said. “I anticipate this will be pretty groundbreaking.”
The implant isn’t an option for everyone with AFib, though.
Some atrial fibrillation patients are at very low risk for stroke and wouldn’t benefit from the procedure, said Dr. James Reiss, a clinical cardiac electrophysiologist at PeaceHealth Southwest.
Patients who need blood thinners for other medical reasons wouldn’t benefit either, he said. In addition, some people can’t take blood thinners at all, and since the medication is necessary for 45 days after the procedure, those patients wouldn’t be eligible, Reiss said.
But for many, the implant offers an alternative to warfarin that offers the same — or better — protection against strokes, according to the studies.
“That’s why we wanted to get this here as quickly as possible,” Reiss said.
