December 1, 2005 To prevent strokes in at-risk patients who suffer from atrial fibrillation, an abnormal heart rhythm, researchers have devised a mechanical alternative to common drug treatments. In the procedure, surgeons place a small parachute-like device near the left appendage of the heart. Once there, the device deploys and stops clots from leaving the heart and traveling to the brain. In one study, the device was about 60 percent better than the drug Warfarin at reducing the risk of stroke.
ROYAL OAK, Mich.--More than two million Americans live with a serious heart condition called atrial fibrillation. These patients are five-times more likely to have a stroke. Now, a small device may save thousands of Americans from having a stroke.
Mary Moore is an atrial fibrillation patient who spends her day helping others. A few months ago she, however, was the one who needed help. Doctors told Moore she had atrial fibrillation, a condition that caused the two upper chambers of her heart to quiver instead of beat normally.
"It's just scary when you can feel your heart racing," Moore says. Steven Almany, a cardiologist at Beaumont Hospital in Royal Oak, Mich., says abnormal rhythm can cause a stroke. While the blood thinner Coumadin reduces the chance of a stroke, it comes with its own risks.
"It's one of the forms of what they use for rat poison. You don't try to tell patients that when you put them on the medication, but yeah, it is rat poison," Dr. Almany says.
The watchman procedure may be a better solution. A small parachute-like device is placed near the left appendage of the heart. Once there, the device deploys and stops clots from leaving the heart and traveling to the brain. Dr. Almany says: "When drug-coated stents came, it was a big deal to us. I mean, it's made a huge dent on morbidity in the United States. I would put this as big if not bigger."
In one study, the device was about 60 percent better than Coumadin at reducing the risk of stroke. Moore had the procedure and is off the drug. "I don't have to go get the blood drawn constantly, and I don't have to worry about am I going to take too much, too little. So, that was the biggest thing for me," she says. Now she can enjoy life whole-heartedly.
The watchman procedure may one day help patients who are at risk for stroke but don't have atrial fibrillation. The procedure is not yet FDA approved but is in ongoing trials nationwide.
BACKGROUND: Researchers have developed a new procedure to prevent strokes in people with atrial fibrillation. The pilot trial for the procedure has been completed, and a larger open trial has begun at about 60 sites around the U.S. The main purpose of the procedure is to reduce or eliminate the need for patients to take Coumadin, a blood-thinning medication that is basically rat poison. People taking the medication must be monitored constantly, since too high a dosage leads to excessive bleeding, while too low a dosage leads to increased risk of stroke. Because of this, only 30-40 percent of those who have atrial fibrillation opt to take Coumadin, even though it increases their risk of stroke.
HOW IT WORKS: A permanent implant -- essentially a heart blood filter -- is inserted through the groin and places just behind, or at the opening, of the left atrium of the heart to block it off. That's because more than 90 percent of clots found in patients with atrial fibrillation occur there. This is similar to traditional angioplasty, in which blood flow can be increased through a clogged artery without surgery. An instrument called a catheter is equipped with a tiny balloon to widen the opening in a partially blocked artery.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.