I’m scheduled for ablation #2 in February, at which time I’ve decided on a Watchman implant during the procedure. My reasons?
I want off of anticoagulants. They carry their own risks of bleeding and even hemorrhagic stroke, plus require limiting changes in an active lifestyle, and are not a permanent solution in that they don’t address the substrate, i.e., the cause of increased risk of stroke in someone with an arrhythmia, which is the appendage in the left ventricle where blood pools and coagulates, forming clots when blood flows irregularly.
I want off all cardiology drugs They have unwelcome side effects. My BP and other numbers are fine. My heart is healthy except for, as my cardiologist put it, “just simply afib.” “Just simply”?? I guess that’s still good news
A Watchman is statistically more effective for stroke prophylaxis than drugs; a Watchman drastically reduces my risk of stroke, especially at my age, 82.
I’ve had four cardioversions in the last four months. Ablation #1 was for afib, pulmonary vein cauterization: 50-50 success rate. The cardioversions have all been for A-flutter and tachycardia. An A-flutter ablation, which is my next step, has a 90+% success rate. With this ablation AND a Watchman, I think I might get off the A-fib carousel.
Have any of you had experience with a Watchman device? What is your take?
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Sweetmelody
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Hello Sweetmelody, this procedure is not commonly available in the UK so we don’t get that many reports. Hopefully you will get some encouraging responses from American members. Hope all goes well for you, please let us know how you get on…..
However, even better is the MiniMaze in Houston or Japan if that's an option to you. They have both better results than ablation and Watchman. Of course you have to clamp or resect the left atrial appendage and the surgery is more demanding than catheter ablation. Both surgeons have had older patients than you are though.
I know I mention John Mandrola a lot on here but I find his ‘This Week in Cardiology’ podcasts & his Substack articles invaluable. I have not read a great deal about the watchman device but I am posting his article here. He is not impressed with the evidence in its favour. I have no idea if he’s right or wrong but you might like to read it.
Wow, thanks for sharing, not only is he not a fan, he is sharing the data on bleeding events (where he shows that the device is less affective) and the chance of procedural risk events (where the devise has a high rate of major adverse events). Yikes
I’ve read a bunch of studies. The highly respected EWOLUTION study finds the watchman “safe and effective,” reducing the annual stroke rate to 1.1%. My stroke risk in the general population in my age group is 14%, or even 20% with persistent afib.
Two other major studies, PROTECT AF and PREVAIL, found the procedure to have a 94% success rate. (No guarantees in life, ever.) These studies are worth reading if you’re considering an implant.
I noted Mondola’s major article speaking against the Watchman comes from 2017, with his blog about it from 2021. Six years is a long time when it comes to advances in medicine in this day and age.
I didn’t notice that he himself is involved in published research in this area or claims any particular expertise other than being an EP who reads others’ studies and forms his own opinions.
I believe Mondola cherry-picks what he wants from the PREVAIL study. I choose to cherry pick what I want to, too. (-: People, whether professional or lay, tend to evaluate evidence and come to their own best conclusions, which is exactly what Mondola does and what I have done.
For me, a position at Baptist Health in Louisville KY does not carry with it overwhelming professional and academic gravitas, though I’m sure he is probably a very good doctor. He clearly cares and wants the best for his patients. That’s any doctor’s most important quality.
In my case, my EP has 69 peer-reviewed research publications in which he has participated, is the Director of Electrophysiology at the University of Washington Heart Institute and is on the UW medical school faculty. He has studied and worked with Dr.John Day and others in Utah, where significant advances in EP are coming from.
Making sense of statistics in medical research studies is sort of like going to the racetrack and laying down a bet. So many unknowns despite so many statistics. So we gather the best information we can and take our chances. Doing nothing is not an option for me. I have to make a decision—“lay down my bet.” My research and the resources I’ve consulted have led me to what I consider my best option: a Watchman.
One of the biggest dangers of the Watchman apparently is “operator error,” i.e., a mistake by the doctor that might puncture the heart or result in something else untoward. That’s why I’ve chosen the best of the best, long experienced, a leading figure in EP at one of the top medical institutions in the U.S., to do the procedure.
I think one of the more serious considerations in deciding on a Watchman (which I did not note that Mondola mentioned ) is the 4-5% risk of DRT, device related thrombosis, which can lead to ischemic stroke. A recent study shows that DRT is more frequent in patients with comorbidities, none of which I have. I have taken this into consideration in weighing risks vs. benefits.
Thanks for bringing Dr. Mondola to my attention. I look for information everywhere.
At the end of the day we all have to make our own decisions on the available evidence. As you have decided on the procedure, you have clearly read information from all sides & decided it’s right for you. Wishing you all the best & I do hope you keep this site updated with your progress.
I am in the US. Where will you have ablaand Watchman? I have ad three ablations for afib and atypical flutter. I also have some AT. I was scheduled for Watchman and ablation #4. This was postponed due to another health issue. Please let us up to date on your progress. Best wishes
I replied, but I don’t see it. I must have hit the wrong button. At any rate, I’m a patient at the University of Washington Medical Center. I changed my insurance a few years back precisely so I could go to the University of Washington for my medical care. It’s the best of the best hereabouts.
Good luck to you on this afib merry-go-round we’re on. Yesterday I reverted to Afib out of nowhere around noon. This morning I’m back in sinus rhythm. Round and round we go….. My fingers are crossed hard that my second ablation plus the Watchman will get me off this carousel Rollercoaster is more like it Best wishes
I had a left atrial appendage clip done while I had open heart surgery and thought I would be off blood thinners and my cardiologist said I could stop them but I had a second ablation and now my electrophysiologist wants me to take them! I really don't know what to do at this point!
For how long? My understanding is that blood thinners can be needed for a period of a few months after an ablation then dispensed with if all goes well? I honestly don’t know. But I do know I will be on Eliquis for 45 days after my ablation and Watchman implant, but then taken off if all looks good. One of the reasons I’ve decided on the Watchman is that I do NOT want to be on blood thinners for the rest of my life for a variety of good reasons.
Your cardiologist and electrophysiologist giving you different advice puts you in a bind you shouldn’t be in. What’s up with them? It’s their professional job to consult on your case and agree on the best course of treatment in your case, presenting it to you as a united front. Ditch one of them? Find a doctor you can trust? I don’t have an answer. But if a doctor perplexes me and leaves me hanging, I move on.
I am going to look for someone else because he told me bluntly that all he has to offer me is AV node ablation after my last ablation that he didn't do. I am having a rough time. I've had a pacemaker in 2014, an ablation in 2018, OHS to replace my aortic valve plus the left atrial appendage clip, then in 2023 I had my second ablation which was a complete fail and that electrophysiologist passes me to his PA. She said I could have another ablation but I lost my trust so now I don't know what to do! Sotalol worked but I get long QT so they had to cut my dose. The only one helping now is God.
I went through three cardiologists before I found the one who was right for me. It took several years. A hassle, but worth it in the end. The same thing happened when my beloved PCP retired. I ran into a couple of clunkers before I found one who’s right for me, one who will work in partnership with me and who I have come to trust. Trust is essential. It sure doesn’t help that you don’t trust your providers. Navigating a medical system is an acquired skill, I guess, that takes patience and perseverance. Good luck!
I had a Watchman Flex installed when I had a PCI ablation May 2021. I was in a study at Cleveland Clinic. I was subsequently taken off Eliquis.Followup studies including CT and Transesophogeal Echo show that the device is working well. All I currently take is low dose aspirin and 25 mg metoprolol per day.
Although I needed a second ablation for Aflutter 4 months after the first, I have been in NSR ever since.
Your story is exactly what I’m hoping for! Thanks so much for sharing. I admire the Cleveland Clinic. You don’t know how you lifted my spirits just when I needed it. Thank you! And good luck to you.
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