San Diego Health host Susan Taylor recently sat down with David Brush and his cardiologist, Douglas Gibson, MD, director of cardiac electrophysiology at Scripps Clinic, to discuss the events that led Brush to undergo a relatively new heart procedure involving a device known as the Watchman.
For years, Brush had been living with an irregular heartbeat condition known as atrial fibrillation (AFib). He had undergone a minimally invasive procedure called catheter ablation and was on blood thinning medication to reduce his risk of stroke. Unfortunately, the medication had side effects. It made him dizzy and put him at risk of falling.
“The lightheaded and dizziness were concerning because of the risk of him falling and hitting his head. So we started talking about alternatives,” Dr. Gibson said. “Obviously stopping the blood thinners is not a great alternative because of the risk of a stroke,” Dr. Gibson added.
Dr. Gibson recommended Brush get the Watchman, a medical device that reduces the risk of a stroke and allows certain heart patients with AFib to stop taking blood thinners.
Brush underwent the Watchman minimally invasive procedure in early 2017. “Practically the next day, I started feeling better,” Brush said.
AFib is a quivering or irregular heart beat (arrhythmia) that can lead to blood clots in the left atrial appendage of the heart, stroke, heart failure and other heart-related complications. At least 2.7 million Americans are living with AFib, according to the American Heart Association.
Normally, the heart contracts and relaxes to a regular beat. In AFib, the upper chambers of the heart beat irregularly instead of beating effectively to move blood into the ventricles.
“One of the big problems that occurs is blood can pool in the upper chambers and blood clots can form there and then travel to the brain causing a stroke,” Dr. Gibson said.
About 15 to 20 percent of people who have strokes have AFib, according to the American Heart Association. This clot risk is why patients with this condition are put on blood thinners.
“What we do as a first line of therapy is to treat patients with blood thinners," Dr. Gibson said. “Most often, blood thinners do a great job. They’re life-saving medicines at preventing strokes,” he said.
But when blood thinners alone can't do the job, there are alternatives such as catheter ablation and the Watchman.
In addition to receiving blood thinners, Brush underwent a catheter ablation, a minimally invasive surgical procedure that uses heat to destroy the defective heart tissue that is causing rapid and irregular heartbeats. The procedure helped Brush for a few years until he began experiencing dizziness.
“Most patients who take the blood thinners don’t have a lot of the side effects,” Dr. Gibson said.
Still, blood thinners can increase the risk of dizziness among certain patients, he added. Brush happened to be one.
“Fall risk is a big one particularly among our older patients,” Dr. Gibson said about candidates for the Watchman heart device.
“Often times these patients have orthopedic issues that make them less stable on their feet. A fair number of my patients that I see for Watchman are patients who’ve had falls,” Dr. Gibson said.
The Watchman is a tiny, parachute-like device that is implanted in the heart during a relatively short procedure performed under general anesthesia.
The surgeon inserts a catheter through a small incision in the groin and threads it through a vein up to the heart. The Watchman device is then placed in the heart through the catheter. The device prevents blood clots from developing in the left atrial appendage of the heart. (The Watchman is also known as the Watchman Left Atrial Appendage Closure Device).
Most patients spend one night in the hospital and can usually stop taking their blood-thinning medications 90 days after the implant procedure.
Brush spent one night in the hospital. The next day he started feeling better and managed to go out for a short walk and breakfast.
Three months later, he stopped taking blood thinners and felt the difference right away.
“It was like I had gained a few years back. My vitality was back,” Brush said.