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
We are excited to announce that we have moved our St. Augustine office to a larger office space. We are now located at 100 Whetstone Place, Suite 102, St. Augustine, FL 32086. The office building is at the corner of 312 and Sargent Tutten Drive. Our phone and fax numbers are the same. Phone: 904-342-8300 Fax: 904-342-8301.
According to the Centers for Disease Control and Prevention (CDC), 60% of Americans are not meeting the recommended levels of physical activity. Fully 16% of Americans are not active at all. Overall, women tend to be less active than men, and older people are less likely to get regular physical activity than younger individuals.
In a recent article published in Circulation: Journal of the American Heart Association, researchers from the Harvard Medical School released data from the 10-year Women’s Health study that showed moderate exercise reduced the risk of heart disease by 27% to 41%. the study was performed on 27,055 participants.
The mechanism of benefit was shown to be largely due to the reduction of LDL (bad cholesterol), raising HDL (good cholesterol) and reducing inflammation.
It is well-known that inflammation leads to the release of molecules called cytokines that can cause damage to the blood vessels in the heart and throughout the body. Cholesterol tends to deposit at these damaged sites, leading to plaque. the damaged vessels containing increased cholesterol deposits are the sites where platelets attach to blood vessels. These clumps of platelets can break off and completely block the blood vessel as it narrows downstream. In the coronary arteries, this leads to an acute heart attack; in the brain, it causes either a major or a minor stroke.
As little as two hours of brisk walking every week was sufficient to lower the risk of major cardiac events dramatically. Can you imagine that if all you do is walk briskly for 17 minutes daily, your risk of heart disease will go down by 40%? Regular physical activity is defined as about 30 minutes of moderate activity (preferably all days of the week) can reduce the risk of heart disease. One can lower your chances of having a stroke, colon cancer, high blood pressure, diabetes and other medical problems.
If you’re also trying to manage your weight and prevent gradual, unhealthy weight gain, try to get 60 minutes of moderate to vigorous-intensity activity on most days of the week. At the same time, watch your calorie intake. Take in only enough calories to maintain your weight. I often counsel my patients to eat no more than 350 calories a meal four to six times a day. Most of our bodies cannot metabolize more than this amount so large meals that many of us are used to will cause us to store weight and develop fatty tissue.
I often share the following scenario with my patients:
Patient A – Eats two large meals daily of 750 calories each – totalling 1500 calories.
Patient B – Eats five small meals of 300 calories each about 2-3 hours apart – totalling 1500 calories.
Q: Who will lose weight?
A: Patient B
By eating only the calories the body can burn, patient B will likely lose weight coupled with regular physical activity. Unfortunately, Patient A is unable to burn the extra 450 calories they eat at each meal and that totals 900 extra calories daily. 1 pound is about 3500 calories. In about 4 days, a person can gain an unwanted pound of weight eating this way and it can be exacerbated if they are physically inactive.
Another example: A 200 pound person who keeps on eating the same amount of calories, but walks briskly each day for 1.5 miles, will lose about 14 pounds in one year. Staying active will also help to keep the weight off. Second, you can eat fewer calories and be more active. This is the best way to lose weight, since you’re more likely to be successful by combining a healthful, lower-calorie diet with physical activity.
For example, a 200 pound person who consumes 250 fewer calories per day, and begins to walk briskly for 1.5 miles each day will lose about 40 pounds in one year.
As you can see, about 2/3 of weight loss is attributed to diet, but we need physical activity to help us stave off medical problems including heart disease.
Heart disease occurs when the arteries that supply blood to the heart muscle become hardened and narrowed, due to a buildup of plaque on the arteries’ inner walls. Plaque is the accumulation of fat, cholesterol and other substances. As plaque continues to build up in the arteries, blood flow to the heart is reduced. Heart disease can lead to a heart attack. A heart attack happens when a cholesterol-rich plaque bursts and releases its contents into the bloodstream. This causes a blood clot to form over the plaque, totally blocking blood flow through the artery and preventing vital oxygen and nutrients from getting to the heart. A heart attack can cause permanent damage to the heart muscle. Some people aren’t too concerned about heart disease because they think it can be cured with surgery.
This is a myth. Heart disease is a lifelong condition. It’s true that certain procedures can help blood and oxygen flow more easily to the heart. But the arteries remain damaged, which means you are still more likely to have a heart attack. What’s more, the condition of you blood vessels will steadily worsen unless you make changes in your daily habits and control other factors that increase risk.
You have control.
Physical inactivity is one of several major risk factors for heart disease that you can do something about. The others are:
Smoking. People who smoke are up to six times more likely to suffer a heart attack than non-smokers, and the risk increases with the number of cigarettes smoked each day.
High Blood Pressure. Also known as hypertension, high blood pressure increases your risk of heart disease, stroke, kidney disease, and congestive heart failure.
High Blood Cholesterol. High Blood Cholesterol can lead to the buildup of plaque in your arteries, which raises the risk of a heart attack. Starting at age 20, everyone should have their cholesterol levels checked by means of a blood test called a “lipoprotein profile”. You can lower high blood cholesterol by getting regular physical activity, eating less saturated fat and trans fat, and managing your weight. In some cases, medication is also needed.
Overweight. If you are overweight or obese, you are more likely to develop heart disease even if you have no other risk factors. Ask your doctor to help you determine whether you need to lose weight for your health. The good news: Losing just 5-10% of your current weight will help to lower your risk of heart disease and many other medical disorders.
Diabetes greatly increases your risk for heart disease, stroke, and other serious diseases. Ask your doctor whether you should be tested for it. Many people at high risk for diabetes can prevent or delay the disease by reducing calories as part of a healthy eating plan, and by becoming more physically active.
Some people should get medical advice before starting, or significantly increasing physical activity. Check with your doctor first if you:
Are over 40 years old and not used to moderately energetic activity.
Currently have a heart condition, have developed chest pain within the last month, or have had a heart attack. (Also see the section, “After a Heart Attack”)
Have a parent or sibling who developed heart disease at an early age.
Have any other chronic health problem or risk factors for a chronic disease.
Tend to easily lose your balance or become dizzy.
Feel extremely breathless after mild exertion.
Are on any type of medication.
While physical activity can strengthen the heart, some types of activity may worsen existing heart problems. Warning signals include sudden dizziness, cold sweat, paleness, fainting, extreme breathlessness, or pain or pressure in your upper body. These symptoms may occur during, or just after, an activity. Ignoring these signals and continuing your activity may lead to serious heart problems. Instead, call your doctor right away.
Overall, it is best to get regular comprehensive evaluations to help understand how best to incorporate the right type of exercies in your life to help reduce your risk of heart disease and other illnesses.
First Coast Heart & Vascular Center has made a sincere commitment to excellence that is second to none. We stand by core principles of: Quality, Integrity and Compassion. We will always put our patients first.
In our four main offices covering four counties (Duval, Clay, St. Johns and Flagler), First Coast Heart & Vascular Center provides a wide range of cardiac, vascular & electrophysiological diagnostic testing. We also have satellite offices in Duval County that are conveniently located to serve our patients.
Our physicians service all major hospitals in the Duval, Clay and St. Johns counties including:
Memorial Hospital Jacksonville,
Baptist Hospitals (downtown and South),
St. Vincent Hospital South,
Orange Park Hospital,
Flagler Hospital in St. Augustine,
We are on call 24/7 for our patients. If you are admitted to any of these hospitals, we will be happy to attend to your needs as long as you make it known and request that our doctors see you. We have access to your records from any of our offices or homes and that will ensure that there are no interruptions in your care. It will also cut down on your expenses, health care system expenses and will eliminate duplication and unnecessary testing.
Our main offices are equipped with the latest in Nuclear imaging machines, Echo or Vascular equipment as well as the latest in Electronic Medical Records (EMR) which facilitate getting all your records to your primary care or referring doctors in an expeditious manner and with high efficiency. EMR assures a full circle of care with your referring doctors and hospitals. Our board certified cardiologists offer a spectrum of services including, but not limited to: consultation, diagnostic stress testing (Nuclear), Echocardiography, vascular testing, pacemaker or defibrillator implantation & interrogation, diagnostic cardiac & vascular catheterization (Angiography) and intervention (Stents, Rotablators, Laser, Debulking with Atherectomy, Carotid Artery or Renal Artery Stenting, PFO Closure, etc.).
Dr. Dinesh Pubbi is a board certified electrophysiologist with much successful experience in atrial fibrillation treatment including Atrial Fibrillation Ablation.
Dr. L. Van Crisco welcomes both cardiac and vascular patients and especially complicated vascular patients with special attention to vein disease. He is a nationally recognized interventional cardiologist with a vast experience in both cardiac and vascular intervention as well as structural heart disease.
First Coast Heart and Vascular Center contracts with every major insurance company as well as Medicare, Tricare and Medicaid. We offer a wide range of financial plans for your piece of mind. We will work with you to make your care affordable. Please browse the patient portal where you may access us 24 hours a day or send a scheduling question, billing question, or a comment or suggestion. You will be contacted within ONE business day by knowledgeable professional staff ready to help you.
Our doctors welcome new patients, former patients and patients seeking a second opinion in all of our offices. Our doctors cross cover each other when one is caught up in an emergency or on vacation to make sure your care is not interrupted.
Please help us keep you informed of your care by pointing out which of our doctors you wish to see and which office location you prefer to visit.
We at First Coast Heart & Vascular Center also want you to know that we support our Veterans and our Local Law Enforcement communities; they are here for all of us so we will be here for them.
Thank you for choosing First Coast Heart & Vascular Center, PA and for putting your heart in our hands.
The doctors and staff at First Coast Heart & Vascular Center