There’s a new alternative to prevent stroke in people with atrial fibrillation (AFib).
Atrial fibrillation affects the upper chambers of the heart and causes an irregular heartbeat. The condition can lead to blood clots, stroke, heart failure and other heart-related complications. AFib affects about 2.7 million in the US, according to the American Heart Association. Its real danger is the increased risk for stroke: AFib patients’ stroke risk is at a fivefold increase.
“When the top chamber of the heart beats too quickly, blood doesn’t flow well and it can pool in an area of the heart known as the left atrial appendage [LAA]. This is the most common spot where clots form, and they can travel to the brain and cause a stroke,” said Apoor Patel, MD, director of complex ablations in the NSUH Department of Electrophysiology. Dr. Patel and his colleague, Stuart Beldner, MD, NSUH’s associate director of electrophysiology, recently performed the first Watchman implants on Long Island for several patients.
Anticoagulants (“blood-thinning” medications, like warfarin) are the most common treatment to reduce stroke risk for people with AFib. They are highly effective, said the Journal of Thrombosis and Thrombolysis, but can pose significant bleeding risks.
For example, Charline Calderon, 63, of Jamaica, Queens, was diagnosed with AFib several years ago, but couldn’t tolerate anticoagulants. They caused gastrointestinal bleeding and resulted in three hospitalizations for her in the past year. Ms. Calderon was the first to receive the Watchman implant at NSUH.
Made by Boston Scientific Inc., and approved in more than 70 countries, the Watchman looks like a tiny mesh parachute. Cardiologists use a catheter to guide the device, which is compressed to about the size of a quarter, through a leg vein up to the heart for deployment. The Watchman expands and attaches to the LAA, closing off the area to prevent possible blood clots from entering the bloodstream and causing a stroke.
The one-time, minimally invasive procedure takes about an hour under general anesthesia. Afterward, patients typically stay in the hospital for 24 hours. See the Watchman Implant procedure here.
More Freedom, No Medication Side Effects
Twenty-four hours after her Watchman implant, Ms. Calderon said, “I feel great.” Accompanied by her husband of 45 years, Hector, and their three grandchildren, she said that with the device, “I have more freedom — no routine blood tests at the clinic; I can eat more green vegetables.” Most importantly, she added, “It’s a lot easier knowing that my risk for stroke is very low.”
“Blood-thinner medications are the mainstay of therapy for preventing stroke for patients with AFib,” Dr. Patel said. “The Watchman gives an alternative to those who can’t tolerate anticoagulants. This breakthrough can benefit a lot of AFib patients.”
“This new device is truly life-changing for our patients in protecting them against stroke,” said Dr. Beldner. “It is unusual for a device to replace medications. This is the future of stroke prevention and AFib.”
The Calderons, who both recently retired, enjoy trips in their camper and spending time with their family. In recent years, they have visited the Grand Canyon, Mount Rushmore and Las Vegas, as well as local campgrounds in New York, New Jersey and Pennsylvania.
“Now that I'm off the blood thinners, I’m looking forward to being more relaxed on the road with my family,” Ms. Calderon said.
Find more news about health, wellness, medical discoveries and community programs from LIJ Medical Center and North Shore University Hospital in Vitality magazine.
Heart Implant Prevents Stroke
Cardiologists at North Shore University Hospital were the first on Long Island to implant a heart device that prevents stroke in patients with an irregular heart beat known as atrial fibrillation (AFib) as an alternative to long-term blood-thinning medications. Patients with AFib have a five times greater risk of stroke. Doctors performed the recently FDA-approved WATCHMAN heart implant procedure on patients in June 2015.