What Is the Watchman?
In my role as a respiratory therapist, I often conduct EKGs at the hospital. During a recent session with a kind gentleman in his 70s, the computer interpretation revealed an "atrial paced rhythm." Intrigued, I inquired if he had a pacemaker, to which he replied, "Yes. And I also have a Watchman."
Although he did not delve into details about his pacemaker, his enthusiasm was palpable when he shared his experience with the Watchman™. "Interestingly, during the initial implantation, they discovered it was too small. They had to remove it and replace it with a larger one. Now, I have the bigger Watchman in my chest."
His excitement about the Watchman piqued my interest, as I was more familiar with pacemakers than this particular device. Inspired by our conversation, I delved into research on the Watchman device. Here is what I learned.
Who may benefit from a Watchman?
Atrial fibrillation, or A-fib, is an irregular heartbeat. It occurs when multiple areas of your atria become excitable, causing your heart to quiver. While there are effective treatments that can make it go away for many patients, for some it becomes permanent. A-Fib may cause blood to build up in the left atrial appendage. This is a small pouch in the left atria of the heart.1-5
As blood pools, it increases the risk of blood clot formation. These clots may travel through your bloodstream to the brain. Here, they may obstruct blood flow, ultimately leading to strokes.1-5
To mitigate this risk, doctors frequently prescribe anticoagulants, commonly known as blood thinners. However, some people may not tolerate anticoagulants. And it is for these people that the Watchman device may present a valuable alternative.4,5
The device is about the size of a large coin, measuring around 2 to 4 centimeters. As my patient noted, though, there are different sizes. Your doctors will use their expertise to determine which size is best for you.2,4
What is the procedure like?
The Watchman insertion procedure is usually done on an outpatient basis. You are given anesthesia to put you to sleep. While you are sleeping, your doctor inserts a catheter into a vein in your leg. The catheter goes all the way up to your left atrial appendage.2,3
At the end of the catheter is a camera. This helps your doctor determine what size is best for you. The device will then be carefully inserted into your left atrial appendage. After insertion, the Watchman unfurls like an umbrella. As time passes, heart tissue naturally covers the device.2-4
The Watchman is permeable, meaning that blood can still pass through it. But, like a net, it prevents clots from going through it and entering your bloodstream. And this helps prevent A-fib from causing strokes.2-4
The procedure usually takes a couple of hours. Once the device is implanted, you will be monitored for a short time before being allowed to go home. You should be able to return to your usual activities within a few days. However, some doctors may prefer you not to return to your regular activities for a week.2
The device and procedure have been an option for doctors since the early 2000s. And it was approved by the US Food and Drug Administration (FDA) in 2015. So, it is well tested and proven safe and effective for patients with A-fib who seek an alternative treatment to anticoagulants.2,4
My closing thoughts
I admit, I had heard of the Watchman before. But before I talked with this gentleman, I thought it was a type of pacemaker. My bad! Learning what I spotlighted above highlights why staying informed matters. Now, I get it – it's a cool device reducing stroke risks in atrial fibrillation. Moments like these remind me to keep learning in healthcare. What I have learned is genuinely impressive. It makes me a better respiratory therapist, ready to chat with my patients armed with fresh information.
What are your thoughts? Did I provide a clear explanation of the Watchman? If you have firsthand experience with heart failure and the Watchman, feel free to share it in the comments below. And if you don't, do you now feel you have a better understanding of what it is? Please share your thoughts in the comments below.
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