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HWN Suggests

Still Negative on Watchman

I have studied the evidence—not the spin–for left atrial appendage occlusion and this much is clear: it is an invasive procedure with a high risk of complications, and when it was compared to anticoagulation, it did not prevent ischemic strokes. Patients who could not take anticoagulants were excluded from the Watchman trials. While the absence of evidence is not the same as evidence of absence of an effect, the data we have on Watchman predicts higher risk patients will likely do worse with Watchman.

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Featured

 Say No to Watchman

Cardiology is on the brink of making a big mistake. We have embraced a new procedure called left atrial appendage occlusion.

 The WATCHMAN Device Review: A New Era for Stroke Prophylaxis

In conclusion, the WATCHMAN device could serve as an attractive and safe procedure for percutaneous closure of the left atrial appendage owing to its low rate of complications. However, future research is warranted on the long-term outcomes of this procedure as well as the optimization of post-procedural anticoagulant therapy.

Articles of Interest

Cardiologist questions use of Boston Scientific Watchman device

“The device is FDA-approved and research suggests it is effective in reducing stroke in people who cannot take blood thinners,” Becker wrote. “The downside: expense, potential complications, and spiraling use as the device begins to be implanted for questionable indications.

Left Atrial Appendage Closure – The WATCHMAN Device

The left atrial appendage is the major source of thrombus formation in patients with non-valvular AF. The WATCHMAN device (Boston Scientific, MA) is a percutaneous left atrial appendage closure device which has been tested prospectively in multiple randomized trials. It offers a new stroke risk reduction option for high-risk patients with non-valvular atrial fibrillation who are seeking an alternative to long-term warfarin therapy.

Reducing Stroke Risk In Atrial Fibrillation – Clip The Left Atrial Appendage

This procedure is performed under a general anaesthetic. The surgeon uses a specially designed device like the Atriclip to place a secure clip onto the outside of the LAA using a minimally invasive camera under telescopic vision. The procedure usually takes 15 to 30 minutes and has a much higher success rate than the Watchman Device (and other such similar devices).

Watchman Device: Death, Stroke and Device Embolization Can Occur Well After Implantation

Most AEs occurred during the implant procedure (59%) or on the day after (15%), but each of the five major AE types exhibited a distinct time course

Watchman vs. Blood Thinners: Alternatives for Patients with Nonvalvular Atrial Fibrillation

New implant technology designed to thwart stroke shows promise for patients with atrial fibrillation who cannot take anticoagulants. Here’s what potential recipients need to know.

What Is A Watchman Device?

In the Watchman trials, the risk of stroke after receiving a Watchman device is overall similar, or non-inferior in clinical trial terms, when it was compared to warfarin for stroke risk reduction. The risk of stroke does not become zero, but it is equivalent to being on a blood thinner but without the major bleeding risks. It does, however, significantly improve a patient’s risk of stroke compared to not taking any blood thinners at all.

What is the WATCHMAN™ device?

The WATCHMAN™ left atrial appendage (LAA) closure implant is a permanent heart implant used to treat atrial fibrillation (afib) not caused by a heart valve problem.

Resources

Watchman

AFib doesn’t have to mean a lifetime of blood thinners. WATCHMAN is a one‑time, minimally invasive procedure that reduces stroke risk and bleeding worry for life.