What is Watchman?
Watchman offers an alternative to lifelong use of warfarin for people with arterial fibrillation not caused by a heart valve problem.
The Watchman implant is minimally invasive, onetime procedure designed to reduce the risk of strokes that originate in the left arterial appendage (LAA). Watchman can eliminate the need for regular blood tests and the diet restrictions that come with warfarin. Watchman is a permanent device that does not have to be replaced and cannot be seen outside the body.
Why do I need Watchman?
Your Cardiologist may recommend a left arterial appendage closure procedure if you have a disease known as Atrial Fibrillation (AF), which occurs when your heart's electrical system is disturbed and your heartbeat becomes irregular.
As your heart contracts with each heartbeat, blood is squeezed out of the left atrium and into the left ventricle (bottom left of your heart). If you have Atrial Fibrillation, blood can't be squeezed out of the atrium effectively and can therefore collect in your left atrial appendage and increase your chances of stroke.
Blood thinning medications are a common treatment for Atrial Fibrillation but they aren't suitable for everyone. If you can't take medication, your Cardiologist will recommend surgery to close the opening of your left atrial appendage.
How do I prepare for he Watchman procedure?
As this procedure is undertaken in hospital you will need to complete your hospital admission paperwork, which the Nepean cardiology staff will provide to you, the return to the admitting hospital at least three days prior to your admission date.
You will need to fast six hours prior to the admission time, however any medications needed during the fasting period (other than those that you've been instructed to cease) can be taken with a sip of water. Please continue to take all medications as normal unless specifically directed by your Cardiologist to cease them. Please bring a list of all current medications or, ideally the medication bottles with you to hospital. You will be required to stay overnight following your procedure for monitoring so please pack a bag accordingly.
What should I expect on the day of my Watchman procedure?
The procedure takes place in a Cath Lab, you will be connected to heart monitors throughout the procedure. During the procedure:
- A cannula will be put in your arm to give you medication
- A local anesthetic to numb the area or a general anesthetic may be given so you don't feel any discomfort
- A special catheter is gently inserted in your groin and guided slowly up to your heart across the wall that separates the right and left side of your heart
- Using X-rays, X-ray dye and echocardiograms, a device is then positioned and expanded at the opening of the left atrial appendage (this acts like a seal or plug and keeps clots from being released)
- The catheter is removed and the device stays in
What happens afterwards?
After your procedure, you'll be transferred to the cardiac ward for monitoring and observation. There, your Cardiologist will be able o determine how long you need to be in hospital for and if you need to take any blood thinning medication. It is advised that you refrain from driving for 24 hours after leaving the hospital.
Are there any risks?
As with any surgery, there are some risks associated with ta left atrial appendage closure procedure. Some of these can include:
- Damage to structures in the heart
- Incomplete closure of the left atrial appendage
- Device becoming dislodged
- Blood clots forming in the device
- Allergic reaction to the device and medications
- Irregular heartbeat, called arrhythmia
- Bruising , bleeding, infection
- Death from this procedure is rare