Five years ago, Naperville resident and 30-year veteran realtor Carol Cobb was diagnosed with atrial fibrillation (a-fib). This common heart rhythm problem comes with some concerning statistics, including a five-fold increase in the risk of stroke caused by a blood clot. And, a-fib related strokes are more frequently disabling or fatal. The good news? This risk can be significantly reduced by taking the blood-thinning medication warfarin.
But in recent years the now retired Cobb began having mixed feelings about taking the drug. She’d developed some skin discoloration that she suspected was due to her medication.
“I worried about the long-term effects of being on Coumadin (a brand of warfarin) and I prayed something would be developed to replace medication,” says Cobb.
Cobb is not alone in her concerns. Despite the stroke risk, almost half of a-fib patients who are eligible for treatment with warfarin are untreated.
“Some patients don’t tolerate the drug well because of stomach bleeding or other problems,” says Moeen Saleem, MD, a cardiologist with Edward Hospital and Midwest Heart-Advocate Medical Group. “Others have balance issues that make them prone to falls and injuries.
“They also may worry about giving up their arthritis medications or other drugs that may interact with the warfarin, or they find it difficult to comply with regular blood tests to ensure the medication level hasn’t become ineffectively low or dangerously high. The doctor has to make a judgment call weighing the pros and cons of taking an anticoagulant.”
Enter WATCHMAN
Earlier in 2015, Cobb’s prayers were answered when Mark Goodwin, MD, an interventional cardiologist with Edward Hospital and Midwest Heart-Advocate Medical Group, told her about the newly approved WATCHMAN left atrial appendage closure device. He said a WATCHMAN implant offers patients whose a-fib isn’t related to a valve problem an option for reducing the risk of stroke without undergoing long-term therapy with warfarin.
In April 2015, Edward Hospital became the first community hospital in Illinois to offer the implant to certain atrial fibrillation patients. Cobb agreed to undergo the procedure at Edward on April 23.
During these catheter-based implants, the physicians insert the WATCHMAN device into a vein in the leg, where it’s guided to a pouch in the heart called the left atrial appendage. This is the area where blood tends to pool and form stroke-causing blood clots in people with a-fib. Once the device is in place, its parachute-like component is opened. When expanded, the WATCHMAN device is about the size of a quarter. This seals off the area, preventing blood clots from traveling through the blood stream to the brain where they can cause a stroke.
The physician team performing Cobb’s WATCHMAN implant at Edward Hospital included Dr. Goodwin; Dr. Saleem, who is a specialist in electrophysiology; and Stanley Clark, MD, a cardiovascular disease specialist who is also with Edward Hospital and Midwest Heart-Advocate Medical Group. Dr. Clark operates the imaging technology that helps guide and monitor the WATCHMAN implant.
Above / The WATCHMAN device is implanted in the left atrial appendage of an a-fib patient’s heart, where it seals off the area to prevent blood clots from traveling to the brain where they can cause a stroke.
Cobb’s procedure lasted about an hour and she was discharged from the hospital the next day. On June 11, Cobb got the news she had been waiting for – her follow-up imaging tests showed the implant did seal off her left atrial appendage and she could stop taking Coumadin. As an interim step, she’ll take the medication Plavix, but probably only be for about six months.
“I believe within the next three to five years, this technology will be considered one of the most significant developments in the treatment of atrial fibrillation,” says Dr. Goodwin. “Outside of hospitals involved in the WATCHMAN clinical trials, Edward is one of only a few hospitals in the country offering the implants. It’s a credit to Edward and its commitment to providing patients the best care and access to the newest technology.”
For more information about cardiac care at Edward Hospital, visit www.edward.org/heart.
Story & photos submitted by Keith Hartenberger for Edward-Elmhurst Healthcare
