Watchman Implant

The WATCHMAN implant, a minimally-invasive left atrial appendage closure (LAAC) treatment that gives patients with non-valvular AFib an alternative to long-term warfarin medication. This one-time procedure is an important option for people with a history or risk of serious bleeding on blood thinners.


What is Atrial Fibrillation?

Atrial fibrillation (Afib) is an irregular heartbeat that can lead to blood clots forming in the heart. The two upper chambers of the heart (atria) beat irregular and blood doesn’t flow like it normally does from the atria to the two lower chambers of the heart (ventricles). People can have periods of atrial fibrillation or permanent atrial fibrillation. An estimated 12.1 million people in the United States will have atrial fibrillation in 2030. Having atrial fibrillation increases your risk of stroke fivefold when compared to those who don’t have it. Patients are typically placed on anticoagulation (blood thinners) to prevent blood clots from forming that can lead to strokes.

Learn more: Atrial Fibrilation

How does the WATCHMAN implant work?

People with AFib are at increased risk of stroke, mainly due to blood clots that form in the left atrial appendage, a small sac in the top left chamber of the heart. Watchman is a treatment that reduces the risk of blood clots from entering the bloodstream and causing a stroke in patients with non-valvular AFib.

Watchman implant

During the Watchman procedure, a flexible tube is guided through the veins of the leg to the left atrial appendage. When the Watchman device is deployed, it closes off the appendage and is left permanently fixed in the heart. The Watchman device does not need to be replaced and does not require open heart surgery. The procedure typically takes one and a half hours and patients recover in the hospital for 24 to 48 hours.

Is the WATCHMAN procedure right for you?

The WATCHMAN procedure is an FDA approved procedure available to patients with non-valvular (not related to a heart valve condition) atrial fibrillation who are unable to tolerate a blood thinner like Coumadin or novel oral anticoagulants or if you have a lifestyle that increases your risk of bleeding on blood thinners. This one time procedure is an alternative method to reduce stroke related to atrial fibrillation. The WATCHMAN device is inserted through the femoral vein (groin) on a catheter and is implanted in the left atrial appendage of the heart where blood clots form in patient with atrial fibrillation. The WATCHMAN device closes off this area preventing blood clots from forming and potentially leading to stroke.

All patients need a CT scan prior to the procedure to determine if their anatomy is compatible with the WATCHMAN device.

The procedure is done under general anesthesia. A special echo (transesophageal echocardiogram) is done during the procedure to guide the device in the heart. A catheter is placed in the right groin area through the vein and the device is guided up to the heart. The procedure takes about one to two hours. Post procedure, patients can expect to stay one night in the hospital for observation. There is limited down time required.

Learn more (video)


How to Prepare

Day of Procedure

After the Procedure

Self-Care after the procedure

Activity

  • Do not do strenuous exercise and do not lift, pull, or push anything heavy until your doctor says it is okay. This may be for a day or two. Most people can return to regular activities in a few days.
  • Try not to walk up stairs for the first couple of days. This will help the catheter site to heal.
  • Rest when you feel tired.

Diet

  • Eat heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium, alcohol, and sugar.
  • If your bowel movements are not regular right after the procedure, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Patients are required to take anticoagulation in the form of Coumadin or a novel oral anticoagulant such as Apixaban (Eliquis) in addition to a baby Aspirin after the procedure for 45 days until a transesophageal echocardiogram is performed showing the left atrial appendage is completely sealed off by the WATCHMAN device. At this point, patients are transitioned to a baby Aspirin and Clopidogrel (Plavix) which is an antiplatelet medication for 5 months. After 5 months, the Clopidogrel (Plavix) is stopped and patients only require a baby Aspirin indefinitely. In clinical trials, 96% of patients were able to stop taking blood thinners just 45 days after the WATCHMAN procedure.
    (Kar, S., et al, Primary Outcome Evaluation of the Next Generation LAAC Device: Results from the PINNACLE FLX Trial, Circulation, 2021.)

Care of the catheter site

  • For 1 or 2 days, keep a bandage over the spot where the catheter was inserted. The bandage probably will fall off in this time.
  • Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Put a thin cloth between the ice and your skin.
  • You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
  • Do not soak the catheter site until it is healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
  • Watch for bleeding from the site. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
  • If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or seek immediate medical care.

Other instructions

  • Carry your device identification card with you at all times.
  • For 6 months after having the LAA closure, be sure to tell all of your doctors and your dentist that you have the device in your heart. This is important because you may need to take antibiotics before certain procedures to prevent infection.

Meet our Watchman Procedure Providers:

Name Specialties Location
Bhatt, Paras Satish, MD Bhatt, Paras Satish, MD
4.9 /5
153 surveys
860.889.9180
  • Cardiac Electrophysiology
  • Cardiovascular Medicine
  • Internal Medicine
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  • Norwich
  • Hartford
  • Mystic
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Carreras, Edward Thomas, MD, FACC, FSCAI Carreras, Edward Thomas, MD, FACC, FSCAI 203.380.3910
  • Cardiovascular Medicine
  • Echocardiography
  • Internal Medicine
  • Interventional Cardiology
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  • Stratford
  • Bridgeport
  • Milford
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Haider, Jawad, MD, FACC, RPVI Haider, Jawad, MD, FACC, RPVI 860.242.8756
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Bloomfield
  • Hartford
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Jumper, Robert Duva, MD Jumper, Robert Duva, MD 203.445.7093
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Trumbull
Lorenz, David Patrick, MD, FACC Lorenz, David Patrick, MD, FACC 203.845.2160
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Endovascular Medicine
  • Internal Medicine
  • Vascular Medicine
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  • Norwalk
  • Bridgeport
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Moskowitz, Craig Barry, MD, FACC, FHRS Moskowitz, Craig Barry, MD, FACC, FHRS
4.8 /5
130 surveys
860.972.1506
  • Cardiac Electrophysiology
  • Cardiovascular Medicine
  • Echocardiography
  • Internal Medicine
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  • Hartford
  • Hartford
  • Wallingford
  • Waterbury
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Piccirillo, Bryan James, MD Piccirillo, Bryan James, MD 860.972.3570
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Internal Medicine
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  • Hartford
  • Norwich
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Portnay, Edward Lowell, MD, FACC, FSCAI Portnay, Edward Lowell, MD, FACC, FSCAI 203.353.1133
  • Cardiovascular Medicine
  • Internal Medicine
  • Interventional Cardiology
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  • Stamford
  • Fairfield
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Rouse, Charles Joseph, MD, FACC Rouse, Charles Joseph, MD, FACC 203.353.1133
  • Cardiac Electrophysiology
  • Stamford
  • Fairfield
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Selter, Jared Gideon, MD, FACC Selter, Jared Gideon, MD, FACC 203.445.7093
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Internal Medicine
  • Nuclear Cardiology
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  • Trumbull
  • Bridgeport
  • Fairfield
Show Less

Locations: