WATCHMAN Device for Left Atrial Appendage Closure

AFib Increases Your Risk of Stroke 
If you have atrial fibrillation (AFib), you have a five-time greater risk of having a stroke. AFib prevents the top two chambers of your heart, called the atria, from fully contracting. As a result, blood can pool inside of a small sac called the left atrial appendage, forming a blood clot that can travel to the brain and cause a stroke.

Anticoagulants vs. LAAC Devices to Prevent Stroke
While most people with AFib take anticoagulants, a type of blood-thinning medication, to reduce their stroke risk, some people can’t because they have a history of bleeding or they are at risk for bleeding.

Left atrial appendage closure is a minimally invasive catheterization procedure or a surgical procedure during which a medical device is implanted to permanently block the left atrial appendage. This prevents blood clots from forming or escaping. Research shows that left atrial appendage closure devices are as effective as anticoagulants at preventing stroke in people with AFib.

Types of LAAC Devices
Duke offers three left atrial appendage closure devices. 

• The WATCHMAN™ Implant is the most common and safest option. It is shaped like a parachute and is placed using minimally invasive techniques. 
• The Amulet™ is a newer option with a different design and is also placed with minimally invasive techniques. 
• The AtriClip® requires open heart surgery. The clip seals the opening to the left atrial appendage.

The WATCHMAN Implant is placed by an electrophysiologist -- a specialist in treating arrhythmias like AFib. The minimally invasive, catheterization procedure is performed in a sterile room called an electrophysiology lab that has specialized equipment.

Procedure Steps
After you receive general anesthesia, an electrophysiologist makes a small incision in your groin to access your femoral vein. The doctor will insert two thin catheters (long, flexible tubes) into the vein and guide them to your heart. The first catheter will position a small ultrasound sensor inside your heart, allowing doctors to see what they are doing in real-time. The doctor uses the second catheter to pass tiny tools to the heart and access the left atrium. Then they place the WATCHMAN Implant and ensure no blood is leaking around it. Finally, they release the device, remove the catheters, and stich up the access incision. The procedure usually takes about an hour.

Watch to learn more about the WATCHMAN Implant.

Recovery and Follow-Up
After a few hours of monitoring in a recovery room, your doctor will determine if you can return home the same day or if you should spend one night in the hospital for observation.

You’ll need to limit activity for the first week after the procedure while the incision site heals. You may take medications for about six weeks while the internal areas around the device heal. After six weeks, you’ll have a follow-up appointment to ensure the device is working properly.

The WATCHMAN Implant should not need to be replaced. Although metal, the device is MRI-compatible.

Risks
As with any catheterization procedure, risks include bleeding, infection, blood clots, and fluid build-up around the heart. These risks are very low.

Your doctor may recommend one or more of the following tests to create images of your heart and blood vessels. This will help them determine whether you are a candidate for left atrial appendage closure and what size device you need.

CT Scan or MRI
While you lie on a bed, your chest is surrounded by a large tube that emits wavelengths.

Transesophageal Echocardiogram (TEE)
A small ultrasound sensor is passed down your throat.

Comprehensive Approach
Our goal is to successfully treat your AFib while offering you the best stroke prevention available. We thoughtfully consider whether anticoagulants or left atrial appendage closure (or both) is best based on your individual risk profile.

We Offer All FDA-Approved Devices
We understand your condition and anatomy are unique. We offer the three FDA-approved left atrial appendage closure devices to ensure you receive the device that is right for you.

Highly Experienced Heart Experts
Duke was the first North Carolina hospital to implant the WATCHMAN device. Our board-certified electrophysiologists and heart surgeons place many WATCHMAN Implants and other left atrial appendage closure devices every year. We offer high success rates, low complication rates, and thorough follow-up care.