From the Research
The Watchman device has a relatively low failure rate for stroke prevention in patients with atrial fibrillation, with a procedural success rate of approximately 95% and a failure rate of about 5%, as demonstrated in the most recent study 1. The device reduces stroke risk by approximately 80% compared to no treatment, which is comparable to warfarin therapy. However, there are specific risks associated with the procedure, including a 2-3% risk of serious complications such as pericardial effusion, device embolization, or procedure-related stroke. Some key points to consider when evaluating the Watchman device for stroke prevention in patients with atrial fibrillation include:
- The device works by physically closing off the left atrial appendage where most stroke-causing blood clots form in atrial fibrillation patients.
- Patients require post-procedure anticoagulation therapy, typically with warfarin for 45 days followed by dual antiplatelet therapy for 6 months, then lifelong aspirin.
- Long-term device-related thrombus formation occurs in about 3-4% of patients, which may increase stroke risk if not managed properly.
- Regular follow-up with echocardiography is essential to ensure proper device positioning and function.
- Patient selection is crucial, as those with certain anatomical features or contraindications to short-term anticoagulation may not be suitable candidates, as noted in studies 2, 3. The most recent and highest quality study 1 supports the use of the Watchman device as a viable option for stroke prevention in patients with atrial fibrillation, particularly those with contraindications to anticoagulation. Some of the benefits of the Watchman device include:
- Reduced risk of stroke and systemic embolism
- Lower risk of major bleeding compared to long-term anticoagulation
- Potential for improved quality of life and reduced morbidity and mortality. Overall, the Watchman device is a valuable treatment option for patients with atrial fibrillation who are at high risk of stroke and systemic embolism, and who may not be suitable candidates for long-term anticoagulation, as supported by the evidence 1, 4.