How to Prevent Strokes in Non-Valvular AFib Patient | Atrium Health

By John Holshouser, MD

Every year, more than 125,000 strokes in the US are caused by atrial fibrillation (AFib), including 40 percent of strokes in patients over age 80. But up to a third of AFib patients aren’t candidates for long-term anticoagulation to prevent these strokes, because of factors like past major bleeding episodes. What’s more, 30 percent of patients who are prescribed anticoagulants will stop taking them within two years, likely because they’re worried about their bleeding risk and/or don’t grasp the stroke danger.

These patients need an alternative that can prevent strokes long-term. Enter the WATCHMAN^TM device – the only FDA-approved alternative to anticoagulants in patients with non-valvular AFib.

How the WATCHMAN Device Works

WATCHMAN is designed to prevent the 90 to 95 percent of strokes caused by clots that start when blood pools in the left atrial appendage (LAA).

WATCHMAN is guided into the LAA via catheter. The device is designed to conform to the LAA and is covered in a fabric-like coating that promotes endothelialization. This helps the body form a tissue barrier over WATCHMAN that blocks the LAA and prevents blood from pooling and clotting.

It takes about an hour to implant the device and most patients spend one night in the hospital. They continue taking anticoagulants for six weeks, followed by 18 weeks of dual anti-platelet therapy. Then patients transition to aspirin if transesophageal echocardiography (TEE) confirms that the LAA is sealed off.

Effective Stroke Prevention

Five-year follow-up data from the PREVAIL and PROTECT-AF trials indicate WATCHMAN is comparable to warfarin – a commonly prescribed anticoagulant – for stroke prevention in patients with non-valvular AFib. The trials also showed that WATCHMAN patients see a 52 percent decrease in non-procedure related major bleeding episodes and a 27 percent reduction in all-cause mortality, compared to patients who take warfarin long-term.

What’s more, WATCHMAN significantly improves quality of life because it doesn’t need to be maintained or replaced. Patients undergo a single procedure instead of enduring the frequent blood tests and dosage changes that go along with anticoagulants. And patients can stop worrying about increased bruising or bleeding.

The Sanger Advantage

Sanger Heart & Vascular Institute played a key role in the clinical trials that led to WATCHMAN’s approval, and our cardiac catheterization lab has some of the highest WATCHMAN volumes in the Carolinas.

Each WATCHMAN patient is discussed at our team conference, which brings together cardiologists, imaging specialists, surgeons and other experts to look at patients from every angle and come up with the best possible treatment plan. In fact, we’ve implanted more than 100 of the devices and TEE imaging has showed that the device effectively seals the LAA in about 95 percent of our patients. Our team carefully tracks these results and watches for complications—and our rolling complication rate is extremely low thus far.

We’re also enrolling patients in the ASAP-TOO trial that investigates whether WATCHMAN reduces stroke risk in non-valvular AFib patients who can’t take anticoagulants at all, because of bleeding risk or overall intolerance.

This means we have the comprehensive experience and expertise to know when WATCHMAN is a good match for your patient, and to give them the best opportunity for a good outcome.

For more information, or to make a referral, call 877-999-7484.