WATCHMAN Device

Interesting research, but I'm not ready to sign up just yet.deseretnews.com/article/865...

[BobD Volunteer]

Watchman has been around for probably five or six years if not longer but not suitable or available for everyone. I believe in UK it can be used where a patient has a high risks of bleeding which makes anticoagulants unwise.

[seasider18]

It is one of several such devices. The latest one the Amplatzer Amulet has a bigger selection of sizes. Another option is to use keyhole surgery to remove the appendage. Some surgeons remove the appendage when doing bypass and heart valve surgery, Unfortunately my one did not do that. With such a big chance of going into AF after heart surgery it would make sense.

[Thomps95]

I was surprised by the statement: "Up to 40 percent of atrial fibrillation patients cannot tolerate blood thinners like warfarin". I've been urging people on this forum to be more sensitive to those who cannot tolerate anticoagulation but that figure seems much higher than I expected - I'll try to check into it

[PeterWh in reply to Thomps95]

Seems like a marketing number by manufacturer's!!!

[Hidden in reply to PeterWh]

Yes, local newspaper almost giving free advertising for local medical business. Definitely not a balanced article. Several readers commented that the article did not mention possible problems.

[Thomps95]

I just read another article in the Journal of Hematology and Oncology - This group did a close study of 364 patients with atrial fibrillation. 45.4% of them were not prescribed warfarin. However, after reviewing medical charts for reasons why warfarin was not used, the "inappropriate underutilization" rate was only 7.1% (29.5% had documented reasons - which is lower than the estimate of "40% cannot tolerate" above; the rest didn't need it given their CHAD2VAS2 score).

These findings suggest (a) the percentage of people who "cannot tolerate" warfarin is not 40%, but more like 30%; (b) the "panic" over warfarin underutilization is overstated. Yes people need to be aware of the importance of anticoagulation, but we're talking 7% of people with AF who should be taking it but are not. Previous claims of underutilization have been far more "dramatic" than 7% - basically, most people are doing exactly what they should be doing.

[Hidden in reply to Thomps95]

Thanks for looking this up.