Hi guys, so I’ve started to learn that Afib has so many rabbit holes and every treatment is trying to replace the main problem with more problems. I’m starting to slowly accept that my position as a firefighter/EMT might be over within the year but I was reading about the WATCHMAN device. If I could get myself to not take blood thinners for the rest of my young life I think I would cope better with this disease and possibly stay in the fire service. I was wondering if anyone has any experience with this device and any advice. I don’t have another appointment with my EP until the 15th of this month and I have SO many questions. Seeing how my EP last visit dropped the bomb by diagnosing me with PAF and didn’t leave me enough time to ask all my questions, I feel like I’m spiraling down into a deep deep place, almost depression and grieving of the old life I’m losing.
WATCHMAN device? : Hi guys, so I’ve... - Atrial Fibrillati...
WATCHMAN device?
Unfortunately, I think that we go through various losses when we get a diagnosis and do go through grieving but we do come through and adjust with time and many of us also find positives but there is no doubt that this can be life changing.
You may find this thread of interest
healthunlocked.com/afassoci...
If you put Watchman Device in the search box on the top right hand corner you will see all threads on this subject.
As far as I recall, we had 1 lady in the US who had the procedure a few months ago.
Is there a medical reason for you being unable to take anti-coagulants or is it just your preference? All I can say is that I have been on anti-coagulants for 5 years now with no side effects and no issues. I would have thought that having AF is more of an issue for doing a physical job than taking anti-coagulants. Is it a matter of not being able to tolerate them or a fear?
Best wishes CD
I can’t take blood thinners and work in the fire service
Can you have AF and work in the fire service?
If it’s controllled I can
And how will you know it is controlled? Many episodes can be asymptomatic.
Anticoagulants do not thin the blood. Do the same restrictions apply for you?
I'm off blood thinners since February 2019 and I have been ablated on November 2018. I don't think you need to take blood thinners for the rest of your life when you have AFIB. I only took blood thinner for 2 months following my ablation. I didn't have any episode since October by the way.
The Watchman device reduces your risk of stroke. You will still have AF.
I know I’ll still have Afib and always will for the rest of my life. I was hoping I could effectively eliminate or at least reduce my stroke level to blood thinner levels with this procedure
have you done your chads2vasc score?
If you are a 1 or below then you may decide not to take anticoagulants. You will need to take them short term if you decide to have a cardioversion or ablation mdcalc.com/cha2ds2-vasc-sco...
Even if it’s 1, do you think it’s worth the long time risk to be off them? I have to work another 22 years until I can retire
That is down to the individual, I score a one and at age 50 have decided not to take for now. My EP said that in my position he would not take an AC either. It is a gamble though, and you have to decide if the risk is worth taking yourself
I had a hybrid ablation three years ago which included an Atriclip, which works in a similar way to the watchman. I was taken off all medication, including anticoagulents 8 months later. No AF since then, although I deliberately never quite got back to the level of exercise that I did previously. The hybrid or minimaze is more expensive, but seems to have a higher success rate; it may be worth you exploring the possibility.
I have made a lot of posts about my progress over the last couple of years. But briefly my medical advice is no racing, no HIIT, avoid coffee, stress and binge drinking. In the past I would use my HR meter to maximise my effort, regularly hitting my max of 185 and averaging 155. Now I back off when I get to 165. I could probably push a little harder, but its not worth the risk of reverting back into AF.
As a former “victim “ of PAF I’ve been on blood thinners for decades, and must admit the drawbacks are at times overbearing. But I understand that the Watchman device has proved to be quite beneficial to many. It seems the area of rhe Atrium called the atrial appendage is where the blood stagnates and clots form. The watchman is inserted in this area and blocks the blood from entering thus reducing the chances of the formation of a clot.
Sounds like a great idea.
Hi, I was put forward to have a Watchman device fitted due to being unable to take anticoagulants. I have another condition that causes bleeds so was considered a good candidate for the device which stops blood clots forming in the left atrial, although there is still a clot risk in other areas this greatly improves your chances of not having one. I had the procedure on the NHS in UK last year and was fitted with an Amplatzer amulet which was a better fit for me. All went well and now no need for anticoagulant and with more peace of mind I haven't had another AF episode (touch wood) and hardly any ectopics.
Angie
The watchman device requires you to take blood thinners for a total of 8-9 months after the procedure then aspirin for life. It does not treat AF. An ablation requires blood thinners for 1-4 months after if your AF stops and your ChadsVasc2 score is 1 or less. If the ablation is successful, you may get AF again. Your AF is going to continue to worsen if it is not treated. Your quality of life is WAY more important than your job.
You are still in the ‘bargaining phase’ of your diagnosis. I think we all went through this. The truth of it is, there is no bargaining with AF. You need to hit it hard and head on because untreated, it will eventually lead to a stroke and/or heart failure, especially with all of the years you have ahead of you.
Talk to your EP. This is your life.
With the Amplatzer amulet my surgeon does not keep his patients on Warfarin after it although some do for a while. I only had to take Clopidogrel, sold as the brand name Plavix for a month and a 75 mg enteric coated Aspirin for three months.
This must be such a difficult time for you. Can’t offer any info on the device you mention as hadn’t heard of it before. Anti coagulants are a really difficult thing to decide about. My CHAD score was low for many years and the AFib episodes I was aware of seemed to be quite far apart. My GP was happy for me not to take them. I did take aspirin though which seemed like a bit of a compromise. The pattern of my AFib changed to being more often and I needed cardioversion again and then ended up on flecainide. I now, at 64, seem to be on them with a view to it being long term. As other posters have said, it is down to you alone and your attitude to risk. The doctors can advise and you can discuss your CHAD score. But the decision is yours. Try not to panic about all the choices facing you. Do sensible research, weigh up the choices and make informed decisions. Your biggest challenge is about the job that is a vocation for you. How do you square it all off? It depends what triggers your AF. You could do with somebody who is an occupational health professional to talk it all through with. I hope that you get the proper support you need to make your own decisions when the time comes for you to take a particular track through this situation. Gillian
At the present time you will not get a Watchman on the NHS. They did trials of it and the Amplatzer amulet that were successful but placed a moratorium due to cost on making it a regular procedure apart from in certain extreme cases where a patient could not take drugs. I had the Amplatzer fitted privately two years ago. It cost about £10K in Brighton the Watchman quotes I had were more but perhaps because it was Harley Street and London Bridge hospitals.
Hi I have AFIB and had the watchman devise. I feel great , no more blood thinners, except 81 aspirin. Call Boston Scientific for more information.
Noac are not blood thinners, they are anti-coagulants which is taken to reduce the chance of a stroke. In my layman’s understanding of afib, as the heart beats irregularly it can collect blood clots and obviously cause a stroke. The anti-coagulants help to minimise this. I’m sure others on this forum can explain it much better than I, but on a personal note for you don’t worry about taking them, but I appreciate that the fire service have their rules. Good luck and hope your meeting with your EP helps to reassure your mind and feelings. We are all with you
The best thing you could do in this situation imo would be to make an appointment see a really top EP- not for treatment but to get an accurate prognosis. Explain your work, requirements regarding anticoagulation etc.. Whilst he would not be able to take a decision for you, he could provide accurate information on which to base it. One thing which does strike me is that 23 is rather young to have atrial fibrillation. I am wondering if there might be some other, resolvable, condition which might underly the AF. Athletes, for example, often get AF and the treatment for such cases might be different from other patients. I am, of course, speculating a bit here. It seems to me that you need to get highly accurate information before taking any decision.
Don’t lose your life; have it put in (It takes one hospital overnight so they can monitor you and that’s it). I find myself wondering why you wouldn’t do it (I had mine done 4/11/19 and will be off Plavix 6/27/19). I start my vacation in Rome the next day (6/28/29) and LOVE knowing that I can take Advil once again when my knee, etc. acts up again from all the walking. I can hardly wait to get my life back!!!!!!
You had your watchman put in?
Yes, 3 weeks ago... (No more worries about blood-thinners for me again)
BTW, If you go for Ablation, they now close the LAA anyway (clip it closed) since many post-ablation patients wind up being paroxysmal anyway. So you should be able to get off the blood-thinners regardless.
God-speed to you!
Thank you for replying. Are you in the U.S or UK? I feel like it’s a long shot to keep my job now but if I can reduce my chances of stroke without blood thinners I think I have a fighting chance. I’m gonna talk to my EP (finally) on the 15th and see what she says. I hope she can do the procedure or will point me in the direction of it. Why don’t more of us Afibbers do the LAA blockage?
I am in the USA.
Ablutions have been successful to the point that most patients simply look first toward a cure (I.e. they don’t start with a Watchman). More recently, those getting external ablations (I.e. through the ribs) have the LAA tied off while they’re at it as well).
Why tie off the LAA after returning the heart to normal rhythm? Because many many patients experience what’s called paroxysmal A-Fib after ‘successful’ cardioversion (even while taking anti-arrhythmic drugs). In other words A-fib is an unpredictable condition that is best dealt with by closing the LAA regardless (i.e. closing the LAA stops the greatest risk that A-Fib presents).
A final note about CHAD2 scores, etc. The numbers don’t hold up if the patient has paroxysmal A-Fib (which most have). So we’re right back to closing the LAA regardless (unless the patient is older or retired and simply doesn’t have the issues people like you and I have).
I can also be reached at SCSTWO@verizon.net if you’d like. I know how difficult this decision can be.
Sincerely,
Steve
Yes, I understand. MDs think because you are young for some reason you don’t deserve aggressive treatment. You have LIFE to live. Continue your research on the WATCHMAN and let me know and I will do the same.
Hi, I had the Watchman device fitted in 2016 due to not being able to take blood thinners. I believe now that the proceedure is no longer available on the NHS. I have had no problem since the proceedure and have not had to take blood thinners since.
If it had to happen again, I would have it done without even thinking about it! The proceedure itself was pain free, and recovery was excellent, and now there's less worries about blood clots.
If I can help you in any way, please do not hesitate to ask, and good luck with remaining a fireman.
Sharon
Not sure where you are (UK?) but my EP in the US (in Colorado) is a Watchman specialist. Sounds like it may hold some promise for you. Good Luck.
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