Boyd’s Story: Device Offers Peace of Mind of Reduced Stroke Risk

Boyd Smith has lived in Monroe, Ohio, for his entire life, all 87 years of it. He's been married for 63 years to his wife, Virginia, and they have three daughters, four grandchildren, and one great-grandchild. He retired from his bank management job 15 years ago and has loved retirement. By all accounts, Boyd is a lucky man.

Living With Atrial Fibrillation 

Behind the scenes, however, Boyd was dealing with atrial fibrillation for several years. Atrial fibrillation (AFib) is a condition where the heart works hard trying to pump blood. It quivers out of rhythm rather than relaxing and contracting, creating an irregular heartbeat. As a result, blood can pool and create a clot. If the clot breaks away, it can be deadly, causing a stroke.

Boyd had not recognized any symptoms of his atrial fibrillation. His condition was discovered during an unrelated doctor's appointment, which is the case for many people with AFib.  

His doctor prescribed warfarin, a blood-thinning medication, to decrease the risk of an AFib-related stroke. Eventually, he had a pacemaker implanted. “I really felt a difference with the pacemaker,” Boyd says.  As a side effect of the warfarin, Boyd developed bleeding in his gastrointestinal tract and had to be taken off the medication. 

“Patients who need the medication to prevent stroke due to atrial fibrillation are caught between a rock and a hard place,” says Sandeep Gupta, MD, an electrophysiologist at Atrium Medical Center. “They have this risk of bleeding from the medication, or the risk of stroke without the medication.”

Reducing the Risk Of AFib-related Stroke

The pacemaker allowed Dr. Gupta to continue to monitor Boyd's atrial fibrillation, and regular tests indicated his increased risk for stroke.

“I had tests periodically where my pacemaker showed times when my heart went out of rhythm,” Boyd says. “Recently, one of the tests showed that it was out for quite some time. At that point, Dr. Gupta recommended the WATCHMAN™.”

At the time of Boyd's diagnosis with the gastrointestinal bleed, there wasn't another treatment option to lower his risk of AFib-related stroke. Now, however, there is an option that can potentially free people with AFib from the problematic side effects of long-term blood thinners: a left atrial appendage closure (LAAC) using the WATCHMAN device, a permanent implantable device.

A multidisciplinary structural heart team inserts a special device-carrying catheter into a large blood vessel, usually in the groin. Advanced X-rays and ultrasounds are used to help the team gently guide the catheter to the left atrium of the heart. Once in place, the implant device is released.

A spring-action mechanism opens the device and anchors it over the opening to the appendage. Often, patients will describe their experience with left atrial appendage closure as comparable to a cardiac catheterization

“A stroke results from a clot in the left atrial appendage. The WATCHMAN closes the opening, like a plug in the heart chamber,” Dr. Gupta explains. “It closes off the space where blood pools and clots.

“If a person is at risk for stroke, but they are also at risk for falling or getting hurt in a similar way, then blood thinning medication is not an option due to the risk of bleeding,” Dr. Gupta says. “WATCHMAN is the better option to prevent stroke if the patient can't take the medication.”

While patients may not notice a change in how they're feeling physically after the device is implanted, the reduced risk of stroke is the main benefit. “I absolutely have greater peace of mind knowing it's there,” Boyd says.

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