For several years, Hilton Head Medical Center has performed an advanced heart procedure to prevent blood clots that can cause strokes for certain patients with atrial fibrillation (A-fib), the most common heart arrhythmia, which affects the heart’s ability to pump blood.
A Watchman device is implanted in the heart during a procedure known as left atrial appendage occlusion. The approach can help A-fib patients minimize their risk of suffering a stroke and deliver better health outcomes for those who cannot take blood thinners long-term.
The one-time implant is an alternative to blood thinners. While blood thinners themselves can reduce stroke risk, they also pose the risk of bleeding.
That’s why a Watchman implant in the heart can often be a better option, said interventional cardiologist Dr. Timothy Alikakos, of Hilton Head Heart - HIlton Head. And to further strengthen specialized heart care at Hilton Head Medical Center, Alikakos is now performing the Watchman procedure at the hospital.
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Some patients with A-fib don’t have symptoms, “but we still have the issue of preventing blood clots and strokes. That’s when the decision comes down to blood thinners or devices such as the Watchman,” he said. “It has become a safer and easier procedure, partly because of the evolution of the device itself.”
The procedure is minimally invasive and requires a small incision in the upper part of the leg. The Watchman implant is routed to the heart, where it seals the heart’s left atrial appendage to prevent clots from moving. This reduces stroke risk without the need for long-term blood thinners.
Here, Alikakos addresses the benefits of left atrial appendage occlusion.
FAQs about the Watchman heart implant to treat A-fib
Which A-fib patients are candidates for the Watchman heart procedure?
It's an interesting procedure because there aren’t a whole lot of patients who are not candidates. They don’t have to have permanent atrial fibrillation; they can have it off and on. Once you have A-fib, there’s potential for you to have it again. And with that comes the risk of a blood clot forming in the heart and moving to the brain, causing a stroke. People at risk of bleeding are especially excellent candidates for the Watchman procedure because it takes away their need for blood thinners.
Why is eliminating the need for blood thinners a good thing for people with A-fib?
Ultimately this is a preventive procedure meant for people who cannot or should not be on blood thinners. Blood thinners increase your chances of bleeding and other possible complications. There are people of all ages who would do best to come off blood thinners, but then there’s the risk of blood clots and stroke. The Watchman prevents the added risk of blood clots and stroke in that scenario.
This is not open-heart surgery, but it is a procedure where we implant a device which will be permanent. We use a variety of imaging devices, including an intracardiac echocardiography (ICE) catheter, which sits inside the heart and performs cardiac imaging during the procedure. This allows for expediency and low risk for the patient; the procedure has a near-100% success rate.
How long does the Watchman heart implant procedure take, and what can patients expect of recovery?
Ideally the procedure takes less than an hour. Ahead of the procedure we size the patient’s left atrial appendage, using either a CT scan or a heart ultrasound. As for recovery, I tell patients to take it easy for several days after the procedure; don't run any marathons or take too many stairs for about three days.
