WATCHMAN device

The WATCHMAN™ is a small parachute-shaped device about the size of a quarter that prevents blood clots from forming in the left atrial appendage (LAA). The LAA is a small pouch that extends from the heart’s upper left heart chamber (atrium).

People with atrial fibrillation (AFib), a type of irregular heart rhythm, have a high risk of blood pooling and forming clots in the LAA. Traditionally, blood thinners were the only treatment to prevent blood clots in patients with AFib. These medications can have challenging side effects, such as severe bruising or prolonged nosebleeds. The WATCHMAN closes the LAA to prevent clots from forming, without medication.

People who have AFib that isn’t caused by problems with their heart valves may be candidates for the WATCHMAN device. At Penn Medicine, our cardiologists offer the WATCHMAN device to most patients with AFib. This helps ensure our AFib patients experience even better outcomes with a lower risk of blood clots and stroke.

The WATCHMAN is especially beneficial for people who need to avoid taking blood thinners due to risk factors, such as high blood pressure (hypertension) or history of a stroke that increase the risk of severe bleeding. People who work very active jobs or have a higher risk of falling may have more risks associated with taking blood thinners.

Your care team will give you specific instructions to prepare for the WATCHMAN procedure. Most people don’t need to do anything special. You may need to stop taking certain medicines, such as blood thinners, for a brief period. It’s important to give your provider a full list of all medications, including over-the-counter medicines and herbal supplements.

The care team will likely instruct you to stop eating or drinking by midnight on the day of the procedure. Because the procedure uses anesthesia, you’ll need to arrange for someone to drive you home.

The WATCHMAN procedure usually takes about an hour. You receive anesthesia to keep you comfortable during the procedure. An interventional cardiologist, electrophysiologist, interventional echocardiographer and an anesthesia specialist work together to perform the procedure.

During WATCHMAN device placement, a physician:

1. Makes a small incision in your groin and inserts a catheter through a blood vessel
2. Uses imaging to guide the catheter through the vein to your heart
3. Places the WATCHMAN device in the left atrial appendage
4. Removes the catheter and closes the insertion site

You usually stay in the hospital overnight after the WATCHMAN procedure. You may need to lie flat to prevent bleeding at the catheter insertion site. Your care team monitors you for any signs of complications.

After returning home, most people can resume their usual activities within 24 to 48 hours. Your cardiologist will likely advise that you avoid strenuous activity for at least one week.

It’s normal to have some mild pain and bruising around the catheter insertion site for a few days. Call your doctor if you start experiencing any symptoms of complications, such as:

• Bleeding, temperature changes or swelling around the catheter insertion site
• Chest pain or pressure
• Dizziness or fainting
• Excessive sweating
• Fever or chills
• Nausea or vomiting

You continue taking your prescribed blood thinner and aspirin for several weeks after the procedure. Most people can stop taking prescription blood thinners around six weeks after WATCHMAN device placement. You may take daily aspirin for six months or longer.

Studies show that the WATCHMAN device is as effective at preventing blood clots from forming in the left atrial appendage as blood-thinning medications. People who have the WATCHMAN device don’t need to receive regular blood tests or avoid certain foods the way that they do when they are taking blood thinners.

The WATCHMAN procedure is minimally invasive, meaning the chest is not opened to access the heart. By avoiding open-heart surgery, this procedure offers people a faster recovery with less pain and fewer complications. People receiving a WATCHMAN also typically spend less time in the hospital compared to people who have open-heart surgery.

The risks of the WATCHMAN device are low, especially when the procedure is performed by a skilled interventional cardiologist. Rare risks of the WATCHMAN procedure include:

• Blood clots
• Infection
• Pericardial effusion, a buildup of fluid in the membranes around your heart
• Stroke

WATCHMAN device: The Penn Medicine advantage

Penn interventional cardiologists lead the way in catheter-based structural heart disease treatments. When you choose our team, you benefit from:

• History of innovation: Our interventional cardiologists and electrophysiologists were among the first in the nation to use the WATCHMAN device. Today, we continue to stay at the forefront of atrial fibrillation treatment by leading and participating in clinical trials.
• Collaborative care: Interventional cardiologists work closely with the experts in the Penn Cardiac Arrhythmia Program. Our multispecialty approach helps ensure that we find and implement the most effective treatment plan for your needs.
• Lower complication rates: We use the WATCHMAN device in most of our patients with atrial fibrillation. This treatment effectively lowers the risk of blood clots, leading to better outcomes and quality of life for patients with this arrhythmia.