The Watchman device is umbrella mesh like device that can be placed at the opening of left atrial appendage. Using standard techniques, similar to ones used in atrial fibrillation ablation procedure, the Watchman device is guided into the heart through a flexible tube inserted through a vein in your upper leg. With the help of transesophageal echocardiogram, the doctor measures the size of left atrial appendage to determine which size Watchman device to use. Then the doctor deploys the Watchman device at the left atrial appendage. Tug testing is done to make sure that the device is well opposed to the appendage walls. Additional pictures are taken with transesophageal echocardiogram to make sure device is well seated. After confirming the final position, the device is released to leave it permanently implanted in your heart. The patient is observed overnight in the hospital and discharged the next day.
TO PREPARE FOR WATCHMAN DEVICE:
- Ask what medications you are allowed to take. We may also ask you to stop other medications (such as Coumadin (warfarin) and/or aspirin products) several days before your procedure. Your INR (a blood test to evaluate blood clotting) must be within a suitable range to undergo the procedure. If you have diabetes, ask our office how you should adjust your diabetic medications.
- Do not eat or drink anything after midnight the evening before your procedure. If you need to take medications, drink only with a small sip of water.
- When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry or valuables at home.
WHAT TO EXPECT:
- The implant will take place in a special room called the cardiac catheterization or EP (electrophysiology) laboratory. Before the test begins, a nurse will help you get ready. You will lie on a bed and the nurse will start an IV (intravenous) line. This is so the doctors and nurses can give you medications and fluids during the procedure.
- The nurse will connect you to several monitors.
- Your groin area will be shaved and cleansed with an antiseptic solution. Sterile drapes will be placed to cover you from your neck to your feet.
- The procedure is done under anesthesia and the anesthesiologist will remain at the head of the bed to constantly assess you.
- The doctor will insert a catheter into a large blood vessel (in your groin) and advanced it through the blood vessels to your right atrium. A needle is then used to place the catheter through the septum into the left atrium.
- A TEE will then be performed to assess the position and placement of the WATCHMAN device prior to deployment.
- Once proper placement of the device is determined, the device will be deployed and released into the left atrial appendage.
- Upon completion of the procedure, the doctor will assess the position of the device using TEE imaging.
- The implant procedure could take approximately 1 hour.
- The doctor will remove the catheters from your groin and apply pressure to the site to prevent bleeding. You will remain on bed rest for 3 hours.
- After your implant, you will be admitted to the hospital. You will be taken to your room and placed on a special monitor, called telemetry. Telemetry consists of a small box connected by wires to your chest with sticky electrode patches. The box causes your heart rhythm to be displayed on several monitors on the nursing unit. The nurses will be able to observe your heart rate and rhythm.
- Before you leave the hospital, we will discuss the results of the procedure with you and your family. We will also tell you when you can resume activities and how often you will need to have follow-up appointments. If you have any other questions, please call our office.
- Avoid vigorous exertion/exercise for 7 days.
- Do not drive for at least 24 hours after your procedure
- You will be give an appointment for follow-up visit and testing.
Regardless of the results of your study and the course of treatment your physician recommends, you play an important role in staying healthy. Be sure to keep all appointments for exams and follow-up tests. Follow your instructions, don’t hesitate to talk about your concerns, and immediately report any new symptoms.
As always, if you have any questions about your health, be sure to ask your physician or call our office at (602) 456 2342