Video coming soon — Dr. Luni explains watchman / laa occlusion in plain language
Why does AFib increase stroke risk?
In atrial fibrillation, the upper chambers of the heart beat chaotically. Blood can pool and form clots in a small pouch called the left atrial appendage (LAA). If a clot escapes from the LAA and travels to the brain, it causes a stroke. Over 90% of AFib-related strokes originate from the LAA.
Blood thinners (anticoagulants) such as warfarin, apixaban, or rivaroxaban prevent clot formation and significantly reduce stroke risk. But for patients with a history of serious bleeding, blood disorders, or who cannot tolerate anticoagulants, blood thinners are not a safe long-term option.
How does the Watchman work?
The Watchman FLX device is a small, parachute-shaped implant made of nitinol (a flexible metal alloy) covered with a permeable membrane. It is delivered through a catheter inserted through the groin into the heart. The device is positioned at the opening of the left atrial appendage, sealing it off so clots cannot escape.
Over approximately 45 days, the heart's own tissue grows over the device, permanently incorporating it into the heart wall. After the tissue cover is confirmed, anticoagulants can typically be stopped.
What is the Amulet device?
The Amulet (Abbott) is a second FDA-approved LAA occlusion device. It uses a lobe-and-disc design and offers certain advantages in specific anatomies. Dr. Luni implants both Watchman FLX and Amulet and selects the appropriate device based on each patient's individual anatomy and clinical profile.
Who is a candidate for Watchman?
- Patients with non-valvular atrial fibrillation at elevated stroke risk (CHA2DS2-VASc score 2+)
- Patients with a history of serious bleeding on blood thinners
- Patients who have experienced intracranial hemorrhage
- Patients at high fall risk
- Patients with lifestyle considerations that make long-term anticoagulation difficult
Dr. Luni implants both the Watchman FLX (Boston Scientific) and Amulet (Abbott) devices and will help determine which option is best suited to your anatomy and clinical needs.