Sherrie Hendricks didn’t know she had atrial fibrillation until paramedics were driving her from her Vancouver home to the hospital.
About five or six years ago, Sherrie was lying on the couch watching TV. Suddenly, she felt pressure in her chest and arm and she began having trouble breathing. She turned to her husband, Lenny, sitting nearby.
“I told him, ‘You better call someone. I’m in trouble,’ ” Sherrie recalled. “I thought I was having a heart attack.”
Paramedics arrived and checked Sherrie’s heart rate and blood pressure. They told her she was in atrial fibrillation, or AFib.
Sherrie was put on a warfarin blood thinner to prevent blood clots that can cause strokes. But the drug led to even more problems.
Sherrie’s blood vessels started to break, leaving brown spots on her arms. When she bumped into things, she immediately had dark bruises that grew larger over time. And she later developed internal bleeding in her abdomen.
“They said they need to get me off warfarin,” Sherrie Hendricks said.
Fortunately, cardiologists with PeaceHealth Southwest Medical Center and The Vancouver Clinic had recently begun offering a new procedure using a device aimed at preventing blood clots without blood thinners. The device, called a Watchman Left Atrial Appendage Closure implant, was first implanted in a local patient in October 2015.
Hendricks underwent the procedure in September.
“I was kind of worried,” she said. “Who wants somebody to go into your heart with something?”
Out of sync
During atrial fibrillation, the heart’s two upper chambers beat chaotically and irregularly, out of coordination with the lower two chambers of the heart. Patients with atrial fibrillation are at risk of stroke because of a small pouch — the left atrial appendage — on the heart.
Typically, that pouch pulses normally as the heart pumps. But when the heart is in atrial fibrillation, the pouch quivers. 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.
To prevent those clots from forming, many AFib patients who are at risk of stroke receive blood-thinning medication. Those medications, however, come with their own risk: bleeding throughout the body, which could cause another type of stroke.
Another option
The Watchman device gives cardiologists another option. The device essentially seals off the pouch, preventing blood from pooling and clots from forming.
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. The procedure takes about 30 minutes, and patients are sent home after staying overnight for monitoring.
The patient must continue to take the blood thinners for at least 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.
At PeaceHealth Southwest, the outcomes have been even better, said Dr. Jonathan Lowy, a PeaceHealth clinical cardiac electrophysiologist.
Local cardiologists have implanted 110 Watchman devices. Of those who have reached the 45-day post-procedure mark, all but one has been able to stop taking Warfarin, Lowy said. The one who didn’t was taken off of the drug one month later, he said.
“I think it’s been a great success, and we’re really excited to keep offering it to our patients,” Lowy said.
Sense of relief
Hendricks was able to stop taking warfarin 45 days after her procedure. It’s taken several months for the bruising to stop, and the brown spots on her arms are still fading. But Sherrie and Lenny are relieved she doesn’t need the blood thinner anymore.
Sherrie Hendricks’s mother had several strokes, including one after she stopped taking warfarin. Hendricks, 71, was worried about what could happen if she stayed on the drug, but even more concerned about what could happen without it.
“Luckily, we didn’t have to make that decision,” Lenny Hendricks said.
The relief patients feel when they no longer need warfarin is something Lowy said he didn’t fully appreciate before he started performing the Watchman procedure.
“Every day when these patients have to take these medications, it reminds them they have a heart condition,” Lowy said. “When we get them off these strong blood-thinning medications and they only have to take an aspirin, I think it makes them feel better about their health.”
