February 02, 2020
Cookeville Regional is proud to announce that it now offers implantation of the Watchman™ Left Atrial Appendage Closure Device, which can reduce the risk of stroke in patients with atrial fibrillation (AF).
Patients with AF have an increased stroke risk due to clots that can form in the left atrial appendage (LAA), a small chamber in the top of the heart.
“The LAA is a little embryonic remnant that hangs off the side of the left atrium of the heart,” said Dr. Christopher Adams, an interventional cardiologist with Cookeville Regional and Tennessee Heart. “Basically, it’s like the appendix of the heart — it doesn’t do anything that we know of for sure — but blood clots can easily form in there when you have AF.”
While these clots can usually be prevented with anticoagulant (blood-thinning) medications such as warfarin, in some patients, these drugs can cause bleeding issues.
“Not every patient can be on blood-thinning medication, because maybe they’ve had a bleed in the past, such as a brain bleed, a stomach bleed or a GI bleed, or they have recurrent falls, or they don’t tolerate their medication well, and it makes them feel poorly,” said Dr. Adams.
These patients are usually advised to discontinue prescription blood thinners and to only take aspirin, which is not nearly as effective as blood thinners in preventing clots and subsequent strokes, according to Dr. Adams. The Watchman Device offers a new, more effective option for these patients.
Dr. Adams, who has extensive training in the use of the Watchman Device, will be assisted in performing these procedures by Dr. Mark Wathen, an electrophysiologist with CRMC, and Dr. Stacy Brewington, a cardiologist at CRMC.
“The procedure is imagery guided, with patients having a transesophageal echocardiogram (TEE) before, during and after,” said Dr. Adams. “The TEE involves putting a little tube about the size of your pinkie down the throat to get a high-resolution view of the heart and make sure the LAA is the appropriate size and that no clots are present.”
The Watchman Device, which is shaped like a parachute, sits in the left atrial appendage and blocks it off from the rest of the heart. Surgeons enter through a vein in the leg and deploy the device in a procedure that typically takes 45 minutes to an hour. Patients are usually able to go home the next day, and recovery is minimal.