An Alternative to Blood Thinners for Those with AFib

Blood thinning medications are commonly used to treat atrial fibrillation (AFib), a condition that causes an irregular heartbeat. While many people do well with taking blood thinners, they aren’t a great option for everyone. If you have a bleeding problem, a high fall risk or have a high-risk profession or lifestyle, blood thinners may cause an otherwise small injury to be fatal.

What’s the alternative? A minimally invasive catheter based procedure to close the left atrial appendage may be the solution.

Understanding AFib

AFib causes the heart's upper chambers to contract and relax irregularly. This results in an irregular heartbeat, as the upper part of the heart becomes out of sync with the rest of the heart. When AFib is caused by a faulty valve, it’s called valvular AFib. When it’s not, it’s called non-valvular AFib.

AFib causes blood to pool in the left arterial appendage, a small pouch found in the top left of your heart. As blood pools in this appendage, blood cells can stick together and form a clot. This clot can eventually travel out of the heart to other areas throughout the body. If the clot cuts off blood flow to the brain, it can cause a stroke.

If you’re living with atrial fibrillation (AFib), you could be up to five times more likely to experience a stroke.

Alternative Treatments for AFib

There are a few treatments for AFib -- including medications to control heart rate, cardioversion to shock the heart into normal rhythm, and cardiac ablation to create scars that block faulty signals. A newer, common approach to treating AFib is to decrease the most serious side effect of the condition – stroke risk. 

“For people with non-valvular AFib, 90% of clots that lead to stroke form in the left arterial appendage,” shares Kasi Ramanathan, MD, FACC, a structural and interventional cardiologist with the ProMedica Structural Heart Clinic. “I like to call this appendage the appendix of the heart. You don’t need this appendage for your heart to function properly, but like the appendix in the belly, it can be problematic for patients.”

Because this area of the heart is not needed, a device called the WATCHMAN™ Left Atrial Appendage Closure Implant, or a similar device, can be implanted in your heart to permanently close off the appendage.

How Left Atrial Appendage Closure Works

The WATCHMAN implant prevents blood from entering this appendage and prevents clots from escaping. This reduces the risk of a stroke with a one-time, minimally invasive procedure.

A CT scan determines the size of the implant that the heart needs. The interventional cardiologist will then implant the device through the femoral vein in the groin area. This minimally invasive approach helps avoid open heart surgery and significantly reduces recovery time.

After the procedure, patients continue taking blood thinners for at least six weeks. This is to make sure the implant is working properly. Then, most patients can stop taking blood thinners, permanently.

According to Boston Scientific, 96% of people were able to stop their blood thinners 45 days after getting the WATCHMAN implant in a clinical trial.

“This is a very exciting time for structural heart medicine,” Dr. Ramanthan shares. “The WATCHMAN is now in its third generation. The technologies are advancing rapidly which ultimately benefits the patients with more effective and safer devices. This all results in even better outcomes for patients.”

WATCHMAN™ is a registered trademark of Boston Scientific.

Kasi Ramanathan, MD
Dr. Ramanathan is a cardiologist with ProMedica Structural Heart Clinic. View his profile.