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When retired Emmaus High School history teacher Robert “Buzz” Hill received the region’s first Watchman™ device last year, it was a relief knowing the tiny implant could reduce his risk for stroke. He’s already survived two strokes related to a common heart problem, which limited – but didn’t stop – the avid outdoorsman.
“Following recovery from the strokes, I shot my first elk ever in November 2015,” Hill says.
“We weren’t sure he’d make it,” says wife Carolyn of the aftermath of the stroke. Hill went for speech and physical therapy to help his recovery, and today, has a slight weakness in his right side.
Out of sync heartbeat
Among Hill’s heart-related problems, the 80-year-old Lehighton resident suffers from an irregular heartbeat, called atrial fibrillation, or AFib for short. When the two upper chambers of the heart (the atria) contract out of sync with the lower ventricles, atrial fibrillation will occur. It can feel like a fluttering in the chest or a pounding of the heart. Some patients have no AFib symptoms. But what happens inside is important: During AFib, blood can pool in the heart, which can lead to clots forming in the pocket-like left atrial appendage. Those clots can break away and travel to the brain, leading to stroke. An estimated 6 million people in the U.S. suffer from atrial fibrillation.
To prevent clots from forming, many AFib patients are treated with blood-thinning medications, such as warfarin. Though effective, these anti-coagulant medications are not without complications. “People with atrial fibrillation need to be very careful to avoid injuries since their blood doesn’t clot like usual. Also, patients on anti-coagulants can experience unexpected bleeding in the brain, as Mr. Hill did,” says cardiologist Nainesh Patel, MD, with LVPG Cardiology.
Blocking clot pathway
As an alternative to blood thinners, the FDA-approved Watchman device fits just inside the small left atrial appendage (LAA) pocket. “The implant is umbrella-shaped and is designed to plug the mouth of the LAA. It’s also porous, which encourages skin cells to grow over the device,” says cardiologist Babak Bozorgnia, MD, with LVPG Cardiology. That creates a physical block to ensure blood clots can’t leave the LAA and travel to the brain. “Watchman provides patients with atrial fibrillation an alternative to warfarin while reducing the risk for stroke,” says cardiologist Andrew Sumner, MD, with LVPG Cardiology.
In March 2016, Hill received the Watchman implant at Lehigh Valley Hospital–Cedar Crest. During a 75-minute procedure, Patel and Bozorgnia threaded a thin catheter wire holding the compressed Watchman device through a vein in Hill’s leg. The catheter was guided into Hill’s heart, where the Watchman was deployed. “The implant procedure went smoothly, and we’re confident the long-term outlook for Mr. Hill is excellent,” Patel says.
Watchman is not a first-line choice for all patients because blood thinners are effective for many.
“However, for those who have atrial fibrillation and cannot tolerate blood thinners, this is a helpful alternative to have,” Bozorgnia says.
Back to active life
After the porous, umbrella-shaped plug was positioned at the mouth of Hill’s LAA, the next phase of Watchman began. Over the next 45 days, skin cells grew over the device to block blood flow into the LAA. Hill was weaned off warfarin and has been able to return to the forest for hunting.
“I’ve felt great ever since it was put in,” Hill says. “And I feel more normal without the blood thinner.”
Adds Carolyn, “We have a lot fewer worries now. We’re grateful for the Watchman.”