On December 3rd, Electrophysiologist from First Coast Heart and Vascular, Dr. Neil K. Sanghvi, spoke at Flagler Hospital regarding AFib and the Watchman procedure.
WATCHMAN is a one-time, minimally invasive procedure for people with atrial fibrillation not caused by a heart valve problem (also known as non-valvuar AFib) who need an alternative to blood thinners.
Non-valvular Afib can mean a lifetime of blood thinners. It can also mean a lifetime of worry about issues like bleeds and falls. More than 100,000 people have left blood thinners behind with WATCHMAN.
How WATCHMAN Works
To understand how WATCHMAN works, it helps to know more about the connection between atrial fibrillation and stroke.
Atrial fibrillation, or AFib, affects your heart’s ability to pump blood normally. This can cause blood to pool in an area of the heart called the left atrial appendage, or LAA. There, blood cells can stick together and form a clot. When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.1,2
In people with AFib not caused by a heart valve problem, more than 90% of stroke-causing clots that come from the heart are formed in the LAA.1 That’s why closing off this part of the heart is an effective way to reduce stroke risk.
The WATCHMAN Implant fits right into your LAA. It’s designed to permanently close it off and keep those blood clots from escaping. WATCHMAN is about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.
Science always looks for ways to make effective treatments even better. WATCHMAN is no exception. The WATCHMAN FLX design is an advancement that enables the implant to fit a greater number of patients, giving more people than ever a safe, effective alternative to blood thinners should they need one.
In a clinical trial, 96% of people were able to stop taking blood thinners just 45 days after the WATCHMAN procedure.3
One of the most comprehensive studies to date has revealed more evidence that people diagnosed with atrial fibrillation (AFib), a type of rapid or irregular heartbeat may be at greater risk for cognitive decline and dementia.
The new study doesn’t conclude if the association is more than a correlation, and there is no evidence showing atrial fibrillation is an actual cause of cognitive decline or dementia.
Dr. Lin Yee Chen, a cardiac electrophysiologist and associate professor at the University of Minnesota Medical School in Minneapolis who led the study stated that “the short answer is we don’t know. It is too early to say that atrial fibrillation directly causes cognitive decline.”
The new findings, published March 7, 2018 in the Journal of the American Heart Association, come from data gathered on 12,500 women and men from North Carolina, Maryland, Minnesota and Mississippi enrolled in the Atherosclerosis Risk in Communities study. Over half the participants were women and about a quarter were African-American.To read more about the study.
One of First Coast Heart & Vascular Center’s Electrophysiologists, Dr. Neil Sanghvi offers his viewpoint on this interesting study.
“The ARIC-NCS study highlights another risk associated with atrial fibrillation – the risk of worsening cognitive functioning and potential risk of future dementia.
“Asymptomatic” AF may not truly be asymptomatic since these future consequences of long-standing AF need to be considered. Talk to your physician about appropriate management including adequate anticoagulation.”
Recently Dr. Dinesh Pubbi was invited to give a talk at Memorial Hospital here in Jacksonville about the effects of Atrial Fibrillation. Atrial Fibrillation is the most common type of arrhythmia. Dr. Pubbi discussed treatment options, including the Watchman implant device procedure that he performs at Memorial Hospital, to reduce the risk of stroke.
Heart Drug Warfin used to treat AFib tied to Dementia Risk
An interesting study was recently published showing that people with the heart rhythm disorder atrial fibrillation (AF) may be at a greater risk of developing dementia, and the quality of their drug treatment may play a role.
Researchers found that patients on the clot-preventing drug warfarin showed a higher dementia risk if their blood levels of the medication were frequently too high or too low.
This turned out to be true not only for people with AF, but also for those using warfarin for other reasons.
“I believe this study highlights the importance of monitoring warfarin levels closely and to consider alternate anticoagulation options if the warfarin levels are difficult to maintain. Patients should not become concerned if their warfarin level is in range > 75% of the time. This study also supports the importance of using anticoagulation in AF patients since patients with too low warfarin levels were also prone to dementia.”
SOURCES: T. Jared Bunch, M.D., Intermountain Medical Center Heart Institute, Murray, Utah; Gordon Tomaselli, M.D., chief, division of cardiology, Johns Hopkins University, Baltimore, and past president, American Heart Association; May 5, 2016, presentation, Heart Rhythm Society annual meeting, San Francisco
A patient centered support group for discussing and understanding complete heart care. Attendees will find comfort and strength in education and self-awareness. Understand conditions of living with Cardiac Device Assistance, and connect with others to feel a sense of community. This forum is open to the public and free of charge. This group’s affiliation is not for profit.
Dr. Sanghvi was interviewed on First Coast Living and discussed the topics of Atrial Fibrillation, Pacemakers and Implantable Cardiac Devices. Dr. Sanghvi is an Electrophysiologist Cardiologist with First Coast Heart & Vascualr Center.
What is a pacemaker and why would someone need one? Pacemakers are devices that are about the size of a silver dollar. They are placed under the skin usually below the collar bone. They typically have anywhere from 1-3 wires that enter the heart via a blood vessel under the collar bone. These devices are usually placed in patients who suffer from a slow heart beat which results in a number of symptoms including fatigue, shortness of breath, inability to exercise, lightheadedness, or fainting to name a few.
What is a defibrillator, also known as an ICD, and why would someone need one of these devices? ICDs are implantable devices that are placed in similar fashion as a pacemaker. However, an ICD’s job is typically to treat fast and lethal irregular beats known as ventricular tachycardia (VT) or ventricular fibrillation (VF). Many people know that heart disease is the #1 killer in the US. What many do not know is that the reason most patients die is due to untreated VT or VF. Approximately 450,000 people die each year in the US from these arrhythmias. Patients at the highest risk include those who have had a prior heart attack, especially if this has resulted in a weakened heart muscle. Those with a weak heart muscle for other reasons are also at risk. Also, patients who may have had several episodes of passing out without an explanation should be evaluated since a small portion of these patients are likely suffering from VT and/or VF.
If a patient needs to have a device implanted, what type of device should be used? This is a decision that is typically made by the implanting surgeon. There are several manufacturers of devices in the US. Many of the devices have similar features. However, there are some distinct differences.
What happens if there is a problem with one of the wires or if one device type needs to be changed to another? Sometimes these devices may have a wire malfunction or one of the wires may be recalled due to a suspected risk of malfunction. Many surgeons often place a new wire in the heart and leave the old wire abandoned there since they are not capable of taking out the old wire. Unfortunately, this increases the risk of infections and for blood vessels to clot since there is more hardware in the body. Patients should seek out surgeons that specialize in lead extractions. Dr. Neil Sanghvi is able to utilize a laser to carefully and safely tease out the old lead that has scarred into the heart. The risk of a major complication is often less than 1-2% in many cases. The advantage is that it allows for less hardware to remain in the body which decreases the risks of infection and blood vessel clotting.
We are excited to announce that First Coast Heart and Vascular Center physician, Dr. Van Crisco is among the first physicians in Northeast Florida to implant the WATCHMAN device, a novel device for stroke risk reduction for patients with non-valvular atrial fibrillation who have problems taking blood thinners. This procedure is offered at Memorial Hospital in Jacksonville, Florida, thorough the Memorial Structural Heart Program where Dr. Crisco also implants transcatheter aortic valves for severe symptomatic aortic stenosis.
The WATCHMAN device is indicated for patients with non-valvular atrial fibrillation who are looking for an alternative to the long-term use of blood thinners, like Coumadin. The WATCHMAN device is an implantable acorn-shaped plug that closes off an area of the heart called the left atrial appendage where over 90% of clots develop that can lead to stroke. The device is implanted through catheter access from the groin, and prevents damaging blood clots from forming. By shutting off the left atrial appendix, the risk of stroke is diminished, and patients may be able to discontinue taking blood thinners like Coumadin. This procedure is FDA approved and typically requires an overnight stay in hospital.
“For patients with non-valvular atrial fibrillation, the WATCHMAN device gives patients a cutting-edge stroke-risk reduction option.” Dr. Crisco says, “The WATCHMAN device can potentially relieve patients from the complications and bleeding risk issues of long-term blood thinners.”
Atrial Fibrillation is a very common abnormal heart rhythm where the upper chambers of the heart beat with an irregular rhythm, predisposing patients to increased risk for stroke over time. Atrial fibrillation affects over 5 million Americans. Approximately 15-20% of all strokes occur in patients with atrial fibrillation, and strokes from atrial fibrillation are typically more severe then other causes. Currently, Coumadin and other newer anticoagulant blood thinners are the most common treatments to reduce stroke risk in patients with atrial fibrillation. Coumadin specifically, as well as some other blood thinners, is not well tolerated by many patients and carries a significant risk of bleeding complications in particular patients. Almost half of atrial fibrillation patients suitable for Coumadin are currently untreated due to tolerance and adherence issues. WATCHMAN gives these patients an innovative alternative to Coumadin for stroke risk reduction.
To learn more about atrial fibrillation and treatment options to reduce your risk of stroke and to learn about the WATCHMAN device, please call 904.423-0010 to make an appointment. Device specific information is also available at Watchman Implant Device.
What does your sex have to do with it? How to keep your heart ticking.
Join us for a FREE presentation, lunch, and discussion with heart expert Dr. Neil Sanghvi. The event will be held Wednesday, July 29 from Noon to 1pm at the WJCT Studios.
You will benefit from attending this event if you are interested in learning about the facts, symptoms, and treatments of irregular heart rhythms as well as understand the differences between women and men when it comes to heart care.
Surprising but true: Heart failure is more common in women than men, yet women receive treatment 2X less often than men. The focus of this community heart education talk is to discuss available therapies to treat irregular heartbeats and how women are treated differently than men.
Learn more about:
How to decide if a cardiac device is right for uou and life after implant.
The role of catheter ablation for the treatment of atrial fibrillation (Afib).
Men are Mars and Women are from Venus. Does it matter?
Dr. Sanghvi is recognized as a leader in the field of clinical electrophysiology. His interests include atrial fibrillation, novel techniques for stroke prevention, and device therapy for heart failure and irregular rhythms.