New Device May Reduce Risk of Stroke for Afib Patients

A new implant device may be a breakthrough for reducing the stroke risk for atrial fibrillation (Afib) patients. The WATCHMAN Left Atrial Appendage Closure (LAAC) provides a new option for patients with non-valvular Afib, who may require an alternative to long-term use of blood thinners.

UK HealthCare was among the first centers in the world to implant the WATCHMAN as an investigational device through a clinical trial in 2005. The device is now FDA-approved in the U.S. and more widely available.

Higher risk for stroke

Currently, about 5 million Americans are diagnosed with atrial fibrillation, the most common cardiac arrhythmia, where the upper chambers of the heart (atrium) beat too fast and with irregular rhythm (fibrillation). But having an irregular heartbeat is not the only challenge facing these patients. The condition causes them to be at a higher risk of experiencing a stroke – in fact, five times more likely compared to those without atrial fibrillation.

Because the heart does not beat properly in atrial fibrillation patients, blood may not fully pump out of the heart, causing it to pool and then clot in a pouch in the heart’s left atrial appendage. In some cases, the blood clots can break loose and travel in the bloodstream to the brain, resulting in a stroke.

Along with putting patients at a greater risk of experiencing a stroke, these types of strokes caused by atrial fibrillation often are fatal or very disabling.

Finding a new way to treat Afib

In the past, the most common treatment to reduce the risk of stroke in these patients has been to have them take a blood-thinning medication called warfarin. However, despite their effectiveness, taking blood thinners for long periods of time can be difficult for patients because it isn’t always well-tolerated and it presents a significant risk for bleeding complications. Overall, about half of atrial fibrillation patients appropriate for warfarin go untreated because of their inability to tolerate or adhere to the medication.

For patients seeking an alternative to warfarin, the WATCHMAN implant offers a treatment option that could free them from the challenges of long-term blood-thinning therapy. The catheter-delivered heart implant is a one-time procedure that usually takes about an hour.

During the procedure, the implant is designed to close off the left atrial appendage to prevent blood clots from entering the bloodstream that potentially could cause a stroke for higher risk patients with non-valvular Afib.

Once the left atrial appendage is closed off, patients may, over time, be able to stop taking warfarin.

Next steps

Read more about atrial fibrillation »

Learn more about the Gill Heart & Vascular Institute »

Dr. John Gurley

Written by Dr. John C. Gurley, director of the Structural Heart Program at UK HealthCare’s Gill Heart Institute.