Atrial fibrillation (AFib) is the most common irregular heart rhythm that begins in your heart’s upper chambers. Symptoms of AFib include extreme fatigue, heart palpitations, shortness of breath, fainting, chest pain and dizziness. 

Untreated AFib can lead to a stroke and other serious cardiac issues like heart failure. Treatment for AFib focuses on managing the heart rate, preventing blood clots and reducing the risk of stroke and heart failure. The average person with AFib is five times more likely to have a stroke than someone with a regular heartbeat.

AFib is typically treated with anticoagulants (blood thinners); however, there are some patients for whom it is not safe to take blood thinners long term. These patients are now able to receive a one-time, minimally invasive procedure to reduce their risk of stroke without dependency on blood thinners. 

Cape Fear Valley Health began performing the Watchman procedure in September of 2023, with surgeries being done on the first and third Monday of every month. Since its introduction locally, the health system has helped 30 patients to live their lives on their own terms with peace of mind.

Watchman is a small, flexible implant about the size of a quarter, made from very light and compact materials commonly used in many other medical implants. It is placed into your heart and never needs replacement. 

Patients with AFib who are determined to be a candidate for the Watchman procedure are referred for a screening. A specialist then performs an echocardiogram, which involves taking a camera down the throat to take a closer look at the heart, to examine the area where the Watchman needs to be implanted. During this they also take measurements to determine the appropriate size of the device to implant. Once that is finished patients are given a procedure date. 

On procedure day, the patient is put to sleep with anesthesia and the surgery to implant the device takes about 40 minutes from start to finish. Patients then come back to the recovery area where they stay overnight and are then discharged the next day. 

Post op, your doctor will prescribe you blood thinning medication for 45 days or until your LAA (left atrial appendage) is permanently closed off. During this time, heart tissue will grow over the implant to form a barrier against blood clots. At six weeks post op patients have a follow up echocardiogram to check in. Another echocardiogram at their one year follow up as well. Once cleared to stop taking blood thinners, the doctor will then prescribe a medicine to take for six months with aspirin. Once fully healed there is a need for lifelong aspirin therapy to protect against any device related issues such as inflammation.

There is a  newer version of the device, the Watchman Flex Pro, which already has a coating on top of the device to promote faster healing. This is the current device that is used at Cape Fear Valley Health following the national and global guidelines. . 

Cape Fear Valley Health is part of the National Left Atrial Appendage Occlusion Registry and is committed to providing patients with the best possible care. Patients who have undergone the Watchman procedure report greater peace of mind knowing that their risk of stroke has been decreased just the same as when they were taking the blood thinners but without the added risk of bleeding from the blood thinners. 

If you are living with AFib, consult your doctor to find out if the Watchman procedure is right for you.