WATCHMAN™ Left Atrial Appendage Closure (LAAC) Device
Alternative Treatment for Atrial Fibrillation (AFib)
The WATCHMAN™ is the only FDA-approved implant proven to reduce stroke risk in people with atrial fibrillation not caused by a heart valve problem (also known as non-valvular AFib).
Alternative treatment for AFib
The biggest culprit for most strokes in AFib patients is the heart’s left atrial appendage (LAA), where 90% of blood clots develop. The LAA is a finger-like appendage, and each person’s is unique – much like a fingerprint.
The WATCHMAN™ implantable device can stop stroke in atrial fibrillation patients before one happens.
“For many years patients with a high stroke risk would have their LAA surgically removed, which was an open heart surgical procedure," Dr. Latacha said. "This new WATCHMAN device is a game-changer for us."
Dr. Matthew Latacha, electrophysiologist
Methodist Physicians Clinic
Who is a candidate for the WATCHMAN procedure?
Not everyone is a candidate for the WATCHMAN™, which is why Methodist’s team approach to the procedure is so vital. Three specialists join together to evaluate the suitability of the WATCHMAN™ with an AFib patient.
Potential candidates undergo a diagnostic test called a transesophageal echocardiography (TEE) performed by a cardiologist skilled in electrophysiology.
Cardiologist Dr. Tracy Jurrens, electrophysiologist Dr. Matthew Latacha and interventional cardiologist Dr. Edmund Fiksinki trained together to make this evaluation and procedure successful.
LAA measurements crucial for successful placement
During the TEE, measurements are taken of the left atrial appendage size, including the width and depth of the LAA at four standard angles.
"Some appendages have more favorable anatomy, but in general it is better to have smaller width and longer depth. I’m also scanning the appendage for any evidence of clots.”
Dr. Traci Jurrens, cardiologist
Methodist Physicians Clinic
Those measurements are crucial as the WATCHMAN™ comes in five sizes, and proper fit is essential to the device’s ability to stop clots from passing through.
During the TEE the septum — the “wall” that separates the two upper chambers — is also evaluated. At all times prior to and during the procedure the TEE keeps track of any fluid that is accumulating around the heart.
Team approach with real-time imaging
During the WATCHMAN™ procedure, the device is delivered via a transfemoral (groin) approach. A second TEE is conducted with real-time images that help the cardiologist guide the catheter from the femoral vein to the heart, where a small hole is made in the heart’s septum. Doing so provides access to the LAA and the ability to place the device.
“The TEE during the procedure is so important. The correct position during the pass through of the septum is critical. It is in such close proximity to the aorta, so angle and location is crucial. Once we are through the septum, the TEE shows us the real-time images of the appendage and helps us guide the device to proper location.”
Dr. Matthew Latacha
Once properly placed, the device undergoes a “tug” test to assure it’s secure. Additional images are provided for further assessment. During the procedure an interventional cardiologist joins the team, providing a second set of hands and eyes during the procedure.
The benefit of a team approach
Drs. Latacha, Jurrens and Dr. Edmund Fiksinki perform each WATCHMAN™ procedure together. These 3 specialists also trained together to ensure they work seemlesslessly throughout the procedure. When the device, which looks a bit like a jelly-fish, is placed all 3 doctors must agree that they are satisfied with the placement.
What happens after the procedure?
After undergoing the WATCHMAN™ procedure, patients can anticipate an overnight hospital stay. They will go home still on their blood thinning medication as a precaution.
A third TEE is done 45 days after the procedure to assess the device. It’s at this point that nearly 95% of patients are taken off their blood thinner. One year after the procedure that number climbs to 99%.