Watchman procedure is a minimally invasive treatment option for patients with atrial fibrillation (AFib) who are at risk of stroke and are unable to take long-term oral anticoagulant medication. The Watchman device is designed to reduce the risk of stroke by sealing off the left atrial appendage (LAA), which is a small pouch in the heart where blood clots often form in patients with AFib.
Here’s an overview of the Watchman procedure:
- Preparation: Before the procedure, the patient undergoes a thorough evaluation, including medical history review, physical examination, and imaging tests such as transesophageal echocardiography (TEE) to assess the size and shape of the LAA.
- Anesthesia: The procedure is typically performed under general anesthesia to ensure the patient remains comfortable and still during the placement of the device.
- Insertion of the Watchman Device: A catheter (thin, flexible tube) is inserted into a vein in the groin and guided to the heart. Using real-time imaging techniques such as fluoroscopy and TEE, the catheter is advanced into the left atrium and positioned near the opening of the LAA.
- Deployment of the Device: The Watchman device is delivered through the catheter and guided into the LAA. Once properly positioned, the device is expanded to seal off the opening of the LAA, preventing blood clots from forming inside.
- Confirmation and Assessment: After the device is deployed, its position and stability are confirmed using imaging techniques such as TEE or fluoroscopy. The catheter and delivery system are then removed, and the insertion site in the groin is closed with sutures or a closure device.
- Recovery Following the procedure, the patient is monitored in a recovery area for a few hours to ensure there are no immediate complications. Most patients are able to go home the same day or the following day.
- Follow-up: Regular follow-up appointments are scheduled to monitor the placement of the device, assess its effectiveness in preventing stroke, and adjust medications as needed.
The Watchman procedure offers an alternative to long-term oral anticoagulation therapy for patients with AFib who are at risk of stroke but are unable to take blood thinners due to bleeding risk or other factors. Like any medical procedure, there are risks associated with the Watchman procedure, including bleeding, stroke, device migration, and pericardial effusion (fluid buildup around the heart). However, clinical trials have demonstrated that the Watchman device is effective in reducing the risk of stroke in patients with AFib while also potentially reducing the need for long-term anticoagulant therapy.