Atrial fibrillation (AFib) is the most common type of heart arrhythmia, especially amongst older people. It is a condition in which the top chambers of the heart do not beat regularly. Symptoms include fatigue, chest pain, dizziness, difficulty breathing, and heart palpitations. Blood clots in the left atrial appendage may form as a consequence of atrial fibrillation, which may travel to the brain and cause a stroke.
For people with a normal heart rhythm, the left atrial appendage functions normally by rhythmically squeezing along with the rest of the left atrium. This rhythm ensures that blood is released when the left atrium empties into the left ventricle, where it is then pumped throughout the body. When there is a problem with the rate or rhythm of the heartbeat – an atrial fibrillation – it can lead to blood being collected in the left atrial appendage, forming blood clots.
Preventing Atrial Fibrillation Blood Clots from Forming
Blood thinners (anticoagulants) are the most common treatments used to prevent blood clots from forming in people suffering from AFib. However, the trouble with certain blood thinners, such as warfarin, is that they often negatively interact with food, alcohol, and other medications, disrupting a patient’s daily life. The risk of significant bleeding is present, along with the patient having the burden of needing monthly blood tests.
An alternative method for dealing with this problem is a left atrial appendage closure (LACC), which involves removing the left atrial appendage from circulation altogether by closing it off. The Watchman Device was designed to do just that. The Watchman closes off the left atrial appendage, the area from which 90-95% of atrial fibrillation strokes originate.
The Watchman Device
The FDA approved Watchman device was specially designed for patients who are poor candidates for open heart surgery – generally the elderly, who often can’t overcome the risks associated with open heart surgery.
While a patient is under general anesthesia, the doctor will insert the delivery catheter through a vein in the patient’s leg. The catheter is pushed through the bloodstream until it reaches the upper right chamber of the heart. A small hole is made between the two upper chambers of the heart in order to make it through to the left atrium. The doctor then pushes the Watchman device through the deliver catheter into the left atrial appendage, where it opens up like a parachute and is permanently implanted. The procedure takes about one hour to complete.
Within a month and a half, a layer of tissue will grow around it which functions by keeping blood clots in the left atrial appendage from entering the bloodstream.
Certain risks include fever, headaches or migraines, infection, reactions to anesthetic compounds, and allergic reactions to the administered substances, among others.
Post-surgery, the patient is taken to the recovery room and given pain medication. General routine observations are conducted, such as checking the patient’s pulse and blood pressure. The entry wound will also be checked to make sure there is not any bleeding. After a night at the hospital, the patient is allowed to go home the following day.
As the procedure is minimally invasive, recovery should generally be quick. The doctor will advise on or prescribe any medications which should be taken during the recovery period.
Currently, the Watchman device is the leading device used for LAA closures, amounting to over 10,000 cases worldwide.
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Posted by Bumrungrad International
March 02, 2017