Watchman

Dr Gupta just posted a video taking about the watchman and how the NHS is beginning to fund it. He also goes thru the 4 studies that tested it.

Are there downsides or risks to the watchman? If not and money wasn't an object (don't know how much it would cost as a self pay) does it make sense to get it so that you forever avoid bleed risk? Naturally a hypothetical for most people but it seems like it's the Holy Grail for the stroke/bleed problem. Am I missing something?

Also shouldn't it save a bundle to have it done while having an ablation?

[youtu.be]



Edited 1 time(s). Last edit at 06/08/2019 01:55PM by Brian_og.

No, you're not missing anything. If money weren't an issue, I would absolutely get one if I were a CHADS-Vasc 1 or more, or if I were a zero and within a few years of adding a point for age.

The risks are minimal if implanted by an experienced operator, and lower than an ablation. Of the things that can go wrong many are the same as ablations such as bleeding at the insertion sites, perioperative stroke, and pericardial effusion. In addition there's a risk of device embolization and device-related thrombus (DRT) forming, but the risk of embolization is extremely low with an experienced operator and DRT is extremely unlikely if you follow the medication instructions religiously during the first 6 months.

Yes, it would save a bundle and reduce a lot of risk by doing it at the same time as an ablation, but currently that's not standard practice. They like to see a successful ablation before implanting it. But I think we'll see the procedures being combined in the next few years. It makes too much sense not to.

When I tried to get approved I was told that Watchman procedure is Very Expensive and this is why many insurance companies will struggle with approval of the Watchman. This was from Austin also. I am on Medicare....,

You might want to read the post I made a few minutes ago.

I am working on watchman approval thru Austin. I have a chad 3 score, left appendage not working as good as it could, 77 years of age with prostate surgery on the horizon that I will need to be off Eliquis for a day or two minimum.. A few years ago, that would have been enough for approval thru Medicare. Not anymore ! They tell me I need to establish a need to be off a blood thinner for an extended period of time, more than a few days. I am working on that....

If I don't qualify, I will be looking into paying out of pocket. Just a guess, but I bet it would cost 15 to 20 K even if you got the Medicare price. Austin tells me the problem paying out of pocket is that if anything goes wrong, I will be responsible for payments and Medicare wouldn't cover it. That's something to think about.

So, I am just doing the best I can and will try to make the best choice possible.

Ron

Was reading earlier and came across this post where the EP cites two WATCHMAN studies if you're interested in reading the opposing viewpoint.

If there weren't any problems with the Watchman, they wouldn't have run another test trial with an improved Watchman. I wouldn't want the watchman as it is now, perhaps with this new Watchman that they are testing might be a different story.

liz

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Leo J
Was reading earlier and came across this post where the EP cites two WATCHMAN studies if you're interested in reading the opposing viewpoint.

Sigh... Mandrola. Yeah, no thanks, I've read his drivel enough.

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Carey

Was reading earlier and came across this post where the EP cites two WATCHMAN studies if you're interested in reading the opposing viewpoint.

Sigh... Mandrola. Yeah, no thanks, I've read his drivel enough.

Feel free to skip to the studies then

The studies Mandrola is referring to:

[www.ahajournals.org]

[www.onlinejacc.org]

The studies are well known and I've seen them before. I've also seen his articles before and view them with the same disregard that the electrophysiology community views them.

You need to keep in mind that Mandrola's thing is writing a blog and articles for WebMD, and his primary objective is to drive readers to those sites. He does that by writing contrarian, alarmist articles that are literally designed to alarm patients. He always focuses on the risks and never the benefits, his information is quite often dated, and his analyses often wrong. Writing such articles alarms patients and leads them to post links to them, and that gets him more hits, which gets him more attention and more money.

By all means read the studies themselves and form your own judgment, but I recommend ignoring Mandrola. He is not a credible source, IMO.