watchman after care meds

[Fblue]

hi, everyone. I’ve been reading different conflicting things about lifetime aspirin vs stopping after the 6 months after the watchman procedure. I was wondering what those who had one’s protocol is. And how did you do? Thanks so much. Considering this.

[Fblue]

also, do you have to on anticoagulants before like for an ablation?

[mjames1]

I've also read that some also do half dose thinners for life, so add that to the list. Apparently the protocol differs by ep and may also differ patient to patient depending on variables such as CHADs score, afib burden, etc. plus how well the Watchman took which I believe has to be monitored at intervals.

Jim

[Fblue in reply to mjames1]

Thanks Jim. My whole reason for doing it would be to be to get off blood thinners. I don’t tolerate my struggles and so I’m taking aspirin every day for the rest of my life doesn’t sound like a great solution. I’m going to call the AP in my area who sings the watchmen and ask what the after protocol is.

[mjames1 in reply to Fblue]

That would be part of my hesitancy for the watchman as well. Aspirin irritates my stomach.

[Angie06]

I had a LAAO device fitted over 5yrs ago, Amplazer amulet which is the same as a Watchman and stops clots from forming in the left atrial appendage, for people unable to take anticoagulants. I was put on aspirin for 3mths after the procedure and have had nothing since. I've barely had any AF events either. I had my procedure at St Bart's in the UK .

[Fblue in reply to Angie06]

Sounds great! So you did it without an ablation first?

[Angie06 in reply to Fblue]

No ablation as I'm not very symptomatic luckily.

[Fblue in reply to Angie06]

Thanks. That’s the path I am probably on

[Fblue in reply to Angie06]

So if I do the watchman first, can I get an ablation later if needed? Hope you are doing great!

[Angie06 in reply to Fblue]

I honestly can't say as I've never needed to have an ablation.

[oscarfox49]

All I know is that aspirin is a very limited blood thinner and basically ineffective. I took aspirin daily for years and still had a stroke despite this.

[CDreamer in reply to oscarfox49]

Aspirin is an antiplatelet NOT an anticoagulant so that’s why it’s ineffective at preventing AF type induced clots from forming. Antiplatlets are very good at busting up any clots that may have formed so think - Prevention = anticoagulants - before clot forms. Aspirin or antiplatelets = thinning the clots - after clot starts to form. Sometimes you are advised to take both for a limited period to cover all the scenarios. See reply below.

[oscarfox49 in reply to CDreamer]

Thanks for the distinction. I am just still amazed that I was prescribed soluble aspirin for twenty years or more to keep me safe from clotting and strokes with AF, when what you say has probably been known for decades. I think you will find that quite a few people with AF are still prescribed it as if it was an anticoagulant though. I must admit my new doctor in France virtually accused the other member of the practice who had never updated my medication of negligence!

[Cookie24 in reply to CDreamer]

Thanks for this post.

[CDreamer]

If you research the medical libraries you will find some interesting studies which show that some people still need to take an anticoagulant as well as aspirin following the procedure but that was because clots started to form on the device in about 4% of patients so quite low. Look for PROTECT-AF and REVEAL trials.

Based on the postimplantation treatment protocols from the PROTECT AF and PREVAIL trials, the vast majority of Watchman implantations described in the literature were accompanied by warfarin anticoagulation for 45 days, followed by dual antiplatelet therapy (DAPT) for 6 months postprocedure and aspirin thereafter.

I think you will find that US and UK have very different protocols so depends where you live as to availability - in UK NICE guideline dictate who is eligible for such a procedure and it is normally limited to those who are unable to take anticoagulants.

This link will take you to the AA series of videos & info on the LAA closure.

heartrhythmalliance.org/aa/...

[Cookie24 in reply to CDreamer]

Thank you for posting this link. My LAA was isolated during my third ablation. EP is strongly recommending Watchman. I am in the US.

[MummyLuv in reply to CDreamer]

Thanks for sharing this CDreaner, I was about to do the same. The other thing worth highlighting is Left Appendage Occlusion which is a surgical procedure. Most surgeons use a clip called Atriclip to close off the left appendage and it shrivels away to nothing, some still cut it off. The benefit is that there is no longer any risk of stroke caused by the LAA and no blood thinners, anticoagulants, aspirin afterwards. Your EP can’t do this, it is done by a cardio thoracic surgeon. Just throwing into your consideration Cookie24

There is a school of thought the LAA (no matter how you isolate it) helps regulate blood pressure. The right appendage takes over but it is smaller. I have had my LAA isolated and I do notice a small increase in my blood pressure, still well within the normal range so I’m not worried but worth sharing.

[Fblue in reply to MummyLuv]

Such great info. Thank you! And did you just have that procedure and not ablation?

[MummyLuv in reply to Fblue]

I personally had both as I had a failed catheter ablation beforehand.

[Cookie24 in reply to MummyLuv]

Thank you. I am inthe USA. My EP did not describe a surgical procedure for the Watchman. I need further clarification about Watchman and the protocol for after care.

[MummyLuv in reply to Cookie24]

Hi Cookie, it is not a surgical procedure for the watchman it is a totally different approach to isolating your LAA. It does not use the watchman device.