Watchman Device

[Jennywren2953]

I have been reading up on the Watchman device implant to eliminate the use of blood thinners, thanks to some kind people on this site who told me what it was called. I read it has been done for some time and was wondering if anyone here has had the procedure and what they think of it. Many thanks.

[Angie06]

Hi Jenny, I was put forward for the procedure last year and had it done at St Bart's. I ended up having an Amplatzer amulet device which is pretty much the same thing just a different make.

I was unable to take anticoagulants due to another problem and the device has given me more peace of mind although a clot can still form in other parts of the body this is less likely. The procedure was straightforward and done under GA with an overnight stay on the ward. If you want to know more please just ask.

😀

[Jennywren2953 in reply to Angie06]

Hi Angie, thanks so much for your reply, I’m glad it has given you peace of mind, I think that’s what I’m after. My brother in-law passed away last week from a brain haemorrhage after being on blood thinners for 10 years. I’m not sure if I would be eligible for the procedure as I have had pace and ablate. I see my specialist next week so I will see what he thinks.😀

[seasider18]

I had my aortic valve replaced in 2012 that caused me to go into AF and three cardioversions failed (long story) and NOACs are contra indicated with a tissue valve although some EP's over rule that. I was never happy with warfarin's side effects.

I had the Amplatzer fitted in April 2017. It s a simple procedure home the same day if done in the morning. Mine was done late afternoon so I had to stay overnight. If you are in the UK not many people get it done as an NHS patient. I had mine done as a private patient in Sussex and it cost just over £10K. London hospitals are more expensive. I had applied to get on to one of the trials but did not make the list.

I had to take Clopidogrel ( Plavix ) for a month and a mini aspirin for three months

other surgeons have different drug regimes after it. About six weeks later I had an echo cardiogram to check that it was well seated. Other surgeons do a TEE but my one said "That would be cruel" When I had mine fitted he had already done 110 procedures.

Ask if there is anything else you need to now.

[Jennywren2953 in reply to seasider18]

Hi Seasider thanks so much for your reply. I am in Australia and I was pleased to see they do the watchman procedure here, I had never heard of a Amplatzer before. I developed AF in 2016, like you, a long story, 5 cardio versions, primary vein isolation, every pill imaginable, and finally pacemaker and av node ablation, and when I have pacemaker checks I’m still in AF, though I’m not aware of it. I’m concerned about taking blood thinners for the rest of my life so hoping my specialist will give me some advise next week .😀

[seasider18 in reply to Jennywren2953]

There are now other left atrial appendage closure devices coming on line. The Amplatzer has a wider range of sizes and some who go in for a Watchman come out with an Amplatzer.

I'm also in permanent AF that I seldom am aware of and had a pacemaker fitted about a year before the Amplatzer.

When I questioned why I had not been offered another cardioversion after two previous ones had lasted over a year until another medical procedure had disturbed my vagus nerve. I was told that the echo had shown that my right atrium size showed it as unlikely that the cardioversion would be successful. It can be either atrium that is the culprit. However if they first do a cryoablation it may change the size of the right atrium and they can then do a cardioversion. My NHS E.P. asked why do you want to be n NSR anyway.................. If you cant walk

I have a form of neuropathy caused by Cipro and Fluoroquinolone antbiotics and often use a wheelchair when out. It tipped over and gave me quite a violent landing two days after my amplatzer was fitted so I at least proved it was well seated.

[Jennywren2953 in reply to seasider18]

I will have to do some more research on these appendage closure devices. I think anyone who questions why you would want to be in NSR has never experienced being out of it. After my 5th cardioversion my heart went from 180 down to 22, they had had me on Amerodion for a few days prior,so after that the pacemaker went in.

I’m pleased your procedure was a success, thank you for replying😀

[seasider18 in reply to Jennywren2953]

I had my pacemaker as my heart rate was in the low 40's and went down to 37 when asleep with 3.5 second pauses. I had always had a low heart rate apart from the periods in AF and had been quite happy that way. My wife said that I had always had a slow heart rate since she has known me and that is a long time as we have been married for 63 years.

Another patient on the day I had my pacemaker fitted had been found to have a heart rate of 26 bpm . when he went for his pre op assessment for a hip replacement.

Is the Oz Medicare system similar to the American one ?

[Jennywren2953 in reply to seasider18]

We are very lucky to be living in this generation, where we can have pacemakers.Im not sure how the medical system works in America, I have been there a few times and travel insurance to there is very expensive because medical things are expensive there.

[BobD Volunteer]

Just be warned that this and other similar devices are not currently covered by NHS except in some extreme circumstances when anticoagulants are not appropriate for a particular patient. I understand that a trail a year or two back was halted early but have no other details.

[Jennywren2953 in reply to BobD]

Hi Bob thanks for your reply. I am in Australia and read it is covered here by Medicare but you can’t always believe what you read. I’m seeing my specialist next week, so will see how it goes.

[seasider18 in reply to BobD]

My EP said that the trail he was involved in was successful but a two year moratorium was put on the Amplatzer procedure due to its high cost. The two years is now up but I have not seen anything about funding being available.

All recent papers indicate that drugs and devices are equally effective. Would you not like to get off your daily Warfarin if AF is your problem.

[BobD Volunteer in reply to seasider18]

If it ain't broke don't fix it. Nothing is without risks.

[Kazibo in reply to BobD]

hindawi.com/journals/cric/2...

[Kazibo in reply to BobD]

hindawi.com/journals/cric/2...

[Angie06]

Hi Jenny, forgot to say that mine was done just last year on the NHS at St Barts and the only relevant circumstance was that I'm advised not to take anticoagulants due to possible brain bleeds. I think it depends also on where you live as my EP said they were doing a list for this year as well. So worth asking.

[Jennywren2953 in reply to Angie06]

Thanks Angie😀

[walker66]

Hi Jennywren. I had the watchman device fitted in 2016/17. I had it because I couldn't take anti coagulants due to 2 separate strokes, the first being a clot (so was put on anti coagulants), and then the 2nd was a bleed on the brain, so was taken off anti coagulants. The proceedure was fine, and just an overnight hospital stay afterwards. I have had a pace and ablate proceedure since, and then the pacemaker changed the year after to a 2 lead pacemaker with difibrillator and had no problems at all with the watchman device. I can rest easier now I have it about hopefully not having another stroke.

If you have any questions I can help you with, please just ask.

[Jennywren2953 in reply to walker66]

Hi Walker thanks so much, I’m so glad your doing so well, best wishes to you😀

[johnMiosh]

On diagnosis of AF, I was put on Rivaroxaban; my Chads2 and Hasbled scores were both 0, so not a major risk either way. I had one cut to the leg where it bled more than it would have (I believe) but was easy to stop.

I had an Atriclip fitted as part of the mini-maze ablation. I needed an echocardiogram and a TOE to check afterwards.

[Jennywren2953 in reply to johnMiosh]

Thanks for the info John😀

[johnMiosh in reply to Jennywren2953]

Sorry, I should have said a little more. After six months I had a further catheter ablation as part of my planned treatment (hybrid ablation) and came off both Rivaroxaban and Bisoprolol six weeks afterwards. I think that due to my CHAS2 score, I may have stopped anticoagulation even without the Atriclip.

This was nearly two years ago. Since then, I appear to be back to full health; no AF, but I do have a few ectopics now and then.

A report into its effectiveness was published last year. 87% reduction in strokes based on only 166 patients with a much higher CHADS score than me.

ncbi.nlm.nih.gov/pubmed/290...

[Jennywren2953 in reply to johnMiosh]

Thanks John, glad your doing so well😀

[whiststev]

Hello,

My case was different we’re I had the Atri clip fitted during the same time has my bypass surgery , were they fit the clip on the outside of the left atrial appendage

[Jennywren2953 in reply to whiststev]

Thank you for the info😀

[tooh]

Hi Jenny I also live in Qld Australia. I have had a Watchman implanted 6 weeks ago through a trial . I was a candidate because i can't take anticoagulants due to gi bleeds. 2 in last 3 months. The procedure at this stage is not covered by medicare and would cost $10,000.