<?xml version="1.0" encoding="UTF-8"?>
<rss version="2.0" xmlns:dc="http://purl.org/dc/elements/1.1/">
    <channel>
        <title>Best method of LAA Closure</title>
        <description>Is there a preferred, best method of LAA Closure?  My Surgeon said they will use an Atria Clip or suture it closed, depending on what they deem is safer when they are at the site during Surgery. I know about the Watchman but being I am having robotic mitral valve repair surgery, I&#039;d either have the LAA sewed or an Atria Clip inserted. My thoughts are I would prefer the sutures vs an Atria Clip as less foreign objects in my body the better. I&#039;ve also read clots can form around some devices used for LAA Closure so I&#039;m assuming the Atria Clip and Watchman would have possibility for 
Clots to form around them?   If so, wouldn&#039;t sewing the LAA from the inside be the best option?</description>
        <link>https://www.afibbers.org/forum/read.php?9,192942,192942#msg-192942</link>
        <lastBuildDate>Tue, 25 Aug 2026 13:37:05 +0000</lastBuildDate>
        <generator>Phorum 5.2.23</generator>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193012#msg-193012</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193012#msg-193012</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>Makes sense to take thinners if you&#039;re in persistent. However, once in normal rhythm,</strong><br />
</div></blockquote>
<br />
I don&#039;t believe I&#039;ve been in NSR for at least a year probably longer.  I just finished with the Zio Monitor for 14 days and it says 100% AFIB burden.  My EP was very clear on taking Eliquis due to Persistent or Long-Standing Persistent AFIB, regardless of Chadsvasc score at 0 or 1.Thanks for your response and info on this as well as Blood Pressure guidelines.]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 18:43:28 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193009#msg-193009</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193009#msg-193009</link>
            <description><![CDATA[ Makes sense to take thinners if you&#039;re in persistent. However, once in normal rhythm, in general would not make sense at 0 or 1. <br />
<br />
As to whether you&#039;re a 0 or 1, that might be open to interpretation as the the parameters of high bp have changed since the <br />
CHADS score was introduced. At that time above 140/90 was considered &quot;high&quot;. However, your doctor may be calling anything<br />
over 130/80 high, per newer guidelines. <br />
<br />
Interesting article on that here: <br />
<br />
[<a href="https://www.medscape.com/viewarticle/997425?ecd=WNL_trdalrt_pos1_231018_etid5968858&amp;uac=388437PK&amp;impID=5968858"  rel="nofollow">www.medscape.com</a>]<br />
<br />
<br />
Jim]]></description>
            <dc:creator>mjamesone</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 18:13:42 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193008#msg-193008</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193008#msg-193008</link>
            <description><![CDATA[ Thanks. I was assuming it would be closed per previous statements. <br />
<br />
Jim]]></description>
            <dc:creator>mjamesone</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 18:06:11 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193007#msg-193007</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193007#msg-193007</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>With a score of O or 1, you would generally not need to take a thinner, even without any type of LAA Closure, or<br />
am I missing something here?</strong><br />
</div></blockquote>
<br />
My blood pressure 6 months ago was slightly elevated (Diastolic upper 80&#039;s or 90-92) so they gave me a score of 1.  My blood pressure has been within normal range mostly since so I believe I am 0 right now.  Either way, my EP said because I am PERSISTENT, he suggests remaining on Eliquis even at 0 or 1 on the chadsvasc scale. You don&#039;t agree with this?]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 17:52:34 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193006#msg-193006</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193006#msg-193006</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>mjamesone</strong><br />
With a score of O or 1, you would generally not need to take a thinner, even without any type of LAA Closure, or<br />
am I missing something here?</div></blockquote>
<br />
With an isolated LAA you may need to remain on an anticoagulant even if you&#039;re a zero. It depends on how well your LAA continues to pump after the isolation. They generally do a TEE at six months to assess LAA function and if you don&#039;t meet the criteria, it&#039;s either anticoagulants for life or an LAA closure device.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 17:49:13 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193004#msg-193004</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193004#msg-193004</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>cornerbax</strong><br />
<br />
In my case, if my LAA is completely closed with the AtriClip or Suturing, and my ChadsVasc score is either<br />
0 or 1, would it be fine to discontinue Eliquis at some point?  I would think with a complete closure of the LAA<br />
and a 0 or 1 ChadsVasc score I could?</div></blockquote>
<br />
With a score of O or 1, you would generally not need to take a thinner, even without any type of LAA Closure, or<br />
am I missing something here?<br />
<br />
Jim]]></description>
            <dc:creator>mjamesone</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 17:05:26 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,193000#msg-193000</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,193000#msg-193000</link>
            <description><![CDATA[ I was part of a study 16 years ago at Emory University during a mini maze procedure, the LA was clipped shut - not removed or sewed.  My cardiologist wanted to see if it was still closed and any leaks during a latest discussion should I be on an anti-coagulant. My cardiac CT scan revealed that after all these years, it is still closed off and no leaks. They sent this report to the EP&#039;s on staff. I was told I did not need to take Eliquis or any other blood thinner. I can take a low dose aspirin if I wish. I was also told that the ChadVasc score is somewhat arbitrary -  for example, being a female - getting dinged for that is not a factor.  I was also told that there is still not enough data regarding long term requirement use of these drugs after having any type of LAA closure procedure including the Watchman.  Time will tell at some point.]]></description>
            <dc:creator>sldabrowski</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Tue, 24 Oct 2023 13:05:35 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192992#msg-192992</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192992#msg-192992</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>cornerbax</strong><br />
In my case, if my LAA is completely closed with the AtriClip or Suturing, and my ChadsVasc score is either<br />
0 or 1, would it be fine to discontinue Eliquis at some point?  I would think with a complete closure of the LAA<br />
and a 0 or 1 ChadsVasc score I could?</div></blockquote>
<br />
Yes.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 21:26:03 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192991#msg-192991</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192991#msg-192991</link>
            <description><![CDATA[ Thanks Carey,<br />
<br />
I understand now.  I took isolating the LAA as the same as CLOSURE of the LAA, which is not the case<br />
as Daisy explained. I am going to watch that video when I get off of work because I do want to fully<br />
understand the process and the LAA. I also agree that it&#039;s at 0 or close to 0% that in your case all of<br />
those things would happen for 20 years. It&#039;s also good to know you can stop Eliquis with no issues<br />
whenever you need.  That is awesome!<br />
<br />
In my case, if my LAA is completely closed with the AtriClip or Suturing, and my ChadsVasc score is either<br />
0 or 1, would it be fine to discontinue Eliquis at some point?  I would think with a complete closure of the LAA<br />
and a 0 or 1 ChadsVasc score I could?]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 20:17:35 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192990#msg-192990</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192990#msg-192990</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>cornerbax</strong><br />
So closing/isolating the LAA &quot;REDUCES&quot; circulation and &quot;INCREASES&quot; chances of Clots Forming? If that <br />
is the case, wouldn&#039;t it be better to NOT close off/isolate the LAA to begin with?</div></blockquote>
<br />
Isolating the LAA and closing it are two different things. Isolating it is simply creating an ablation line around the mouth of the LAA—it is still open. This is only done in order to stop arrhythmias coming from this area, not to prevent clots. To close the LAA you need a separate procedure, either the implantation of a Watchman, which plugs and seals the LAA, or an AtriClip or suturing (which can only be done during open heart surgery). As Carey said, in your case clipping the LAA would prevent clots by sealing off the LAA.]]></description>
            <dc:creator>Daisy</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 20:02:54 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192989#msg-192989</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192989#msg-192989</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>cornerbax</strong><br />
With that said, would an AtriClip from the OUTSIDE still restrict that circulation and increase the chance of clots in the<br />
LAA as you stated with the Watchman?</div></blockquote>
<br />
No, you&#039;re not understanding the point that the Watchman and Atriclip both completely seal off the LAA. There won&#039;t be blood flowing inside it at all so there&#039;s no way for clots to form. No doubt the blood that&#039;s in there when they seal it will turn to clot, but so what? It can&#039;t go anywhere because the LAA is completely sealed. <a href="https://www.youtube.com/watch?v=1f33kyMh9rM"  rel="nofollow">This short video</a> will help you visualize what&#039;s going on.<br />
<br />
Why would people not choose to remain on Eliquis for life? Because of bleed risk, which increases with age, and because of what Daisy said about having to stop it for procedures. When my LAA was isolated, blood flow in my LAA was poor enough that I was instructed to remain on Eliquis for life and never to miss a single dose. Well, what are the odds I can go the next 20 years without once forgetting a dose or losing my meds or needing surgery or being injured or whatever? I put those odds at exactly zero. A year after my ablation I had the opportunity to join a Watchman FLX clinical trial so I jumped at it. The result is last week I had a colonoscopy and I simply stopped the Eliquis for 5 days like they wanted. I didn&#039;t need to contact Natale and arrange a bridging procedure or anything of the sort. I have standing permission to stop the Eliquis for as long as I wish any time I wish, or even just stop it altogether. That wouldn&#039;t be possible without the Watchman.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 18:22:29 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192988#msg-192988</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192988#msg-192988</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>for instance, you have had your LAA isolated as was necessary to stop my arrhythmias, you cannot stop your anticoagulant safely for even a day. Isolating the LAA reduces the circulation there and increases the likelihood of clots forming</strong><br />
</div></blockquote>
<br />
So closing/isolating the LAA &quot;REDUCES&quot; circulation and &quot;INCREASES&quot; chances of Clots Forming?  If that<br />
is the case, wouldn&#039;t it be better to NOT close off/isolate the LAA to begin with?  In my case my Chadsvasc<br />
score is 1, due to slightly elevated blood pressure which is no longer the case so it may actually be 0 right<br />
now.  Regardless, my EP said because i&#039;m &quot;PERSISTENT&quot; to continue to take Eliquis 2x a day at 5mg each<br />
dose.<br />
<br />
I spoke with my Doctor/Surgeon who would do my Mitral Repair and when I asked about the LAA they said they<br />
either use a Clip, which I assume is the AtriClip or I am pretty sure they said almost this exactly &quot;IF THEY CAN GET<br />
TO IT FROM THE INSIDE THEY WILL SEW IT.&quot;  I know Carey mentioned he was unsure about this but I am <br />
pretty certain that is exactly what they said.  And then they said there are PROS AND CONS to both and I didn&#039;t<br />
ask any additional questions on the LAA at that point but I can definitely clarify.<br />
<br />
With that said, would an AtriClip from the OUTSIDE still restrict that circulation and increase the chance of clots in the<br />
LAA as you stated with the Watchman?]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 17:58:44 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192987#msg-192987</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192987#msg-192987</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>cornerbax</strong><br />
with this known, <br />
wouldn&#039;t it be best for most people to take Eliquis for life vs. having a Watchman implanted?</div></blockquote>
<br />
A couple of things play in here—a significant issue for some of us is that you have to stop your anticoagulant for most surgical procedures and some dental procedures. I just had to stop Eliquis for 4 days for a colonoscopy. If your stroke risk is low this okay, but if, for instance, you have had your LAA isolated as was necessary to stop my arrhythmias, you cannot stop your anticoagulant safely for even a day. Isolating the LAA reduces the circulation there and increases the likelihood of clots forming. So I had to wait until my Watchman was in place for 3 months before my colonoscopy. I and others here, will continue on a half dose of Eliquis indefinitely to cover the 10% of clots not coming from the LAA. Even without LAA isolation, some have a high ChadVASc score and it could be risky to stop anticoagulants for medical procedures.]]></description>
            <dc:creator>Daisy</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 16:59:08 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192986#msg-192986</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192986#msg-192986</link>
            <description><![CDATA[ This is all excellent info. With all of this said, why would someone not want to take eliquis or an anticoagulant all of their lives vs. getting a watchman implanted? I&#039;m guessing that some have bad reactions to anticoagulants or maybe at <br />
some point in time they may not be able to get the anticoagulants and a watchman is permanent? The thing is, Carey said that the Watchman only prevents blood clots coming from the LAA, where 90% of clots from AFIB related clots, but the other 10% come from elsewhere.  <br />
While Anticoagulants eliminate blood clots from ALL areas.  Again, with this known, wouldn&#039;t it be best for most people to take Eliquis for life vs. having a Watchman implanted?]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 15:30:39 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192983#msg-192983</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192983#msg-192983</link>
            <description><![CDATA[ We should know by December 2027 if the Watchman is a reasonable alternative to NOACs.<br />
<a href="https://www.afibbers.org/forum/read.php?9,189353,189520#msg-189520"  rel="nofollow">Prior Discussion Link</a>]]></description>
            <dc:creator>JakeL</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 05:34:06 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192981#msg-192981</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192981#msg-192981</link>
            <description><![CDATA[ This is a pretty good basic link (09/05/2023) explaining which DOAC is more effective and which supplements that may interact.<br />
<br />
“ Direct oral anticoagulants, or DOACs, have been found to be safer than warfarin for patients with atrial fibrillation. A new study published in November 2022 in Annals of Internal Medicine found apibaxan to be the safest blood thinner among DOACs, including dabigatran, edoxaban and rivaroxaban. ”<br />
<br />
[<a href="https://www.drugwatch.com/health/cardiovascular-health/blood-thinners/#:~:text=Direct%20oral%20anticoagulants%2C%20or%20DOACs,including%20dabigatran%2C%20edoxaban%20and%20rivaroxaban"  rel="nofollow">www.drugwatch.com</a>].<br />
<br />
I’m an eliquis fan and Carey also posted his preference as well. I have no problem remaining on 2.5mg BiD.]]></description>
            <dc:creator>susan.d</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Mon, 23 Oct 2023 00:54:06 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192980#msg-192980</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192980#msg-192980</link>
            <description><![CDATA[ The trouble with these kinds of studies is that anticoagulants prevent clots from forming everywhere in the body while a Watchman (and other LAA closure techniques) only prevents them in the LAA. The LAA is the source of 90% of all afib-related clots, but there&#039;s still that 10% that form elsewhere in everyone, even those without afib. So doing direct comparisons between LAA closure devices and anticoagulants is always going to favor the anticoagulants since they have a 10% advantage. <br />
<br />
That final article you linked to briefly alludes to the other side of the coin, which is hemorrhagic strokes. Anticoagulants increase the risk of hemorrhagic strokes but LAA closure devices do not. So to really do a meaningful side-by-side comparison, bleed risks have to be included. And not just hemorrhagic strokes, but GI and other types of bleeds as well. I&#039;ve never seen a study that looked directly at both sides of the coin. <br />
<br />
And there&#039;s also a third side of the coin: compliance. If you look at studies on compliance with anticoagulants, the numbers are terrible. Something like 40% of all people who should be on them eventually either stop taking them altogether or just become so spotty about taking them that they&#039;re ineffective. A study lasting a year or two isn&#039;t going to catch those problems. That needs a longitudinal study lasting many years or even decades, and those are expensive as hell and don&#039;t produce results for years, so they&#039;re hard to justify. After all, will Eliquis and Watchman devices even be relevant 20 years from now?]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 21:31:14 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192979#msg-192979</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192979#msg-192979</link>
            <description><![CDATA[ I found it here.<br />
[<a href="https://www.inquirer.com/health/atrial-fibrillation-watchman-blood-thinners-treatment-20190704.html"  rel="nofollow">www.inquirer.com</a>]<br />
Sketchy or not?<br />
<br />
I like this peer opinion —however published in 2015- not new enough-where are the newer further independent studies done (not from watchman site)?<br />
[<a href="https://pubmed.ncbi.nlm.nih.gov/26709135/"  rel="nofollow">pubmed.ncbi.nlm.nih.gov</a>]<br />
<br />
“ Conclusions: NOAC therapy was superior to warfarin for multiple outcomes while Watchman reduced hemorrhagic stroke. <b>Further studies are needed</b> to assess Watchman versus NOAC to optimize therapy for stroke prevention in AF patients.”<br />
<br />
The current study from 2021:<br />
[<a href="https://www.nmhs.net/news-media/press-releases/2021/nmmc-in-afib-study-blood-thinner-vs-device/"  rel="nofollow">www.nmhs.net</a>]<br />
<br />
Curious on the results.]]></description>
            <dc:creator>susan.d</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 21:02:04 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192978#msg-192978</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192978#msg-192978</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>susan.d</strong><br />
Some say…<br />
<br />
“Apixaban (Eliquis) was the safest, followed by edoxaban (Savaysa), dabigatran (Pradaxa), warfarin (Coumadin) and then rivaroxaban (Xarelto); the Watchman device ranked last. The Watchman device has been advertised heavily, both to the public, in medical journals, and at medical conferences.Jul 4, 2019”<br />
[<a href="https://www.inquirer.com"  rel="nofollow">www.inquirer.com</a>] › health</div></blockquote>
<br />
I can&#039;t find whatever article that came from, but I&#039;d like to see it. The link just goes to the main page, the health section has a zillion articles, and the search feature doesn&#039;t work.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 20:18:05 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192976#msg-192976</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192976#msg-192976</link>
            <description><![CDATA[ Some say…<br />
<br />
“Apixaban (Eliquis) was the safest, followed by edoxaban (Savaysa), dabigatran (Pradaxa), warfarin (Coumadin) and then rivaroxaban (Xarelto); the Watchman device ranked last. The Watchman device has been advertised heavily, both to the public, in medical journals, and at medical conferences.Jul 4, 2019”<br />
[<a href="https://www.inquirer.com"  rel="nofollow">www.inquirer.com</a>] › health]]></description>
            <dc:creator>susan.d</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 18:41:13 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192975#msg-192975</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192975#msg-192975</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>mjamesone</strong><br />
Just so you know, one difference is that with Watchman, low dose aspirin will be required for life to help prevent clots from forming on the Watchman Device itself. </div></blockquote>
<br />
Actually, that&#039;s controversial. It&#039;s what the FDA says, but many EPs disagree and Europe has always disagreed and it&#039;s been in use there longer than here. Two EP Watchman experts explained it to me as being more of a case of the FDA feeling they had to do <i>something</i> rather than basing it on actual data. Over a period of a few months following implantation, your own epithelial tissue grows over the Watchman and completely covers it, so once that&#039;s complete it&#039;s no longer exposed to blood flow and clots <i>can&#039;t</i> form on it. I&#039;ll believe aspirin is needed for life when I see data from Europe showing a higher incidence of stroke among Watchman recipients who aren&#039;t taking aspirin or an anticoagulant.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 18:05:15 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192974#msg-192974</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192974#msg-192974</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>mjamesone</strong><br />
Just so you know, one difference is that with Watchman, low dose aspirin will be required for life to help prevent clots from forming on the Watchman Device itself. Low dose aspirin would not be required with Atriclip. <br />
Jim</div></blockquote>
<br />
Perhaps some EPs recommend that though most don’t from what I have learned. I was not asked to take aspirin at all, rather 2.5 mg of Eliquis and that will be revisited after my 6 month TEE. At that point the choices will be—stop all anticoagulants, continue with 2.5 mg of Eliquis, or a baby aspirin every other day. Since tissue completely covers the Watchman after a few months, it will not attract clots any more than other heart tissue.]]></description>
            <dc:creator>Daisy</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 17:47:53 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192973#msg-192973</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192973#msg-192973</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>endothelialized</strong><br />
</div></blockquote>
<br />
I learn something new and informative every day here, and now I&#039;ve learned a new word as well!  That is excellent and i&#039;m glad to know people who have current Watchman Devices more than that 6 month period of time you mentioned have had it endothelialized.  This goes to answer the question for &quot;Daisy&quot; as well since she won&#039;t need any further surgery and should be endothelialized too.  <br />
<br />
<blockquote class="bbcode"><div><small>Quote<br /></small><strong>Just so you know, one difference is that with Watchman, low dose aspirin will be required for life to help prevent clots from forming on the Watchman Device itself. Low dose aspirin would not be required with Atriclip.</strong><br />
</div></blockquote>  If the device is &quot;endothelialized&quot; why would low dose aspirin be needed?  <br />
<br />
<br />
@ Carey, thank you very much once again.  I did not know those facts on antiarrhythmic drugs, especially for AFIB, that is amazing.  I do know with Flecainide and Propafenone I had my heart shoot up to about 200bpm and had the WORST dizziness/shortness of breath and sweating i&#039;ve ever had. My Afib and Mitral Regurgitation are actually nearly Asymptomatic.  I&#039;ve only had 3 episodes the entire year and both were very short bouts.  I&#039;m sure the Diltiazem is helping, but even before medications it took some significant exertion<br />
to ever get shortness of breath or dizzy.  The Type 1C medications made me almost give up on medication completely.  I&#039;m glad I didn&#039;t, because in my case Diltiazem has helped even lessen the few episodes I already had.  We know the Sotalol has done nothing<br />
for me, but the Diltiazem definitely keeps my rate respectable.  After the 2 week Zio my AVERAGE HR was 85BPM.  That isn&#039;t resting, it just shows &quot;AVERAGE&quot; and while I didn&#039;t have many bad symptoms prior to Diltiazem, I know my heart rate was closer to 100-110<br />
regularly, sometimes even higher, so I am very happy with Diltiazem for me and glad I am on it.]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 17:16:49 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192972#msg-192972</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192972#msg-192972</link>
            <description><![CDATA[ Just so you know, one difference is that with Watchman, low dose aspirin will be required for life to help prevent clots from forming on the Watchman Device itself. Low dose aspirin would not be required with Atriclip. <br />
<br />
Jim]]></description>
            <dc:creator>mjamesone</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 17:15:53 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192968#msg-192968</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192968#msg-192968</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>susan.d</strong><br />
I’m getting a colonoscopy in a week and that was my GI’s first concern-“you need to stop Eliquis for 2 days</div></blockquote>
<br />
I had a colonoscopy last Wednesday (I had been waiting until after my Watchman.) I had to stop Eliquis for 4 days—2 days before, the day of, and one day more because he removed a polyp and it bled enough that he had to put a clip on it—the clip just falls away and it eliminated. I only take 2.5 mg of Eliquis since the Watchman, so I was surprised by the bleeding and ever so thankful that I have a Watchman.]]></description>
            <dc:creator>Daisy</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 15:52:28 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192966#msg-192966</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192966#msg-192966</link>
            <description><![CDATA[ Replacing a Watchman would be major open heart surgery. No one&#039;s going to be doing that just to upgrade to the latest model. Besides, after a few months, a Watchman gets covered by your own endothelial tissue. (That&#039;s what Daisy meant when she said hers would be fully endothelialized by now.) It literally becomes completely encapsulated by your own heart tissue, and once that happens there is no risk of device-related clots forming.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 15:33:20 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192963#msg-192963</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192963#msg-192963</link>
            <description><![CDATA[ Cornerbax: “ On another note Susan are you getting the new <br />
Watchman FLX to replace the non clot version of <br />
Watchman?”<br />
<br />
My watchman hasn’t given me any problems. It’s been ok since 2-22. I had enough surgeries. I’m going to leave it be..especially since my watchman was difficult to insert because my vein from the groin to my heart was twisted, Dr Natale had to work his magic skills to guide it up. Plus my LAA wasn’t a regular shape and I had a large bent LAA shoulder. I don’t think anyone else could had been as gifted.<br />
<br />
Carey would know if it’s worthwhile for patients to get their watchman replaced..or even if it’s possible. The watchman has metal hooks and by now there is heart tissue engulfing it so I speculate it would be difficult to remove annd replace —and what for? What’s the odds of getting a clot now after all this time? Zero?<br />
<br />
Nah, I’m fine with my watchman as is. I’m very grateful I have it. I’m getting a colonoscopy in a week and that was my GI’s first concern-“you need to stop Eliquis for 2 days”. I just replied I have a watchman and can stop for 5 days and it isn’t an issue. I highly recommend anyone to get a watchman from Dr Natale as a first choice …or someone with his skills at TCAI.<br />
[<a href="https://tcainstitute.com/physicians/"  rel="nofollow">tcainstitute.com</a>]<br />
<br />
I follow Dr Rodney Horton from TCAI on Twitter. He repairs watchman’s that were not sealed and leaking. Take a look at his surgical videos. Ahh. His video is down :-(<br />
<br />
[<a href="https://www.afibbers.org/forum/read.php?9,190024,190070#msg-190070"  rel="nofollow">www.afibbers.org</a>]<br />
<br />
Check out TCAI team on Twitter (X) for doctors:<br />
[<a href="https://twitter.com/TCAI_Research/status/1460699202669793282"  rel="nofollow">twitter.com</a>]]]></description>
            <dc:creator>susan.d</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 05:57:28 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192960#msg-192960</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192960#msg-192960</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>cornerbax</strong><br />
Are you planning on getting an upgrade <br />
To the new and safer FLX Watchman <br />
When it&#039;s available?</div></blockquote>
<br />
No, because mine should be endothelialized by now, or will be soon—so no exposed metal. The coating on the new Flex Pro helps with the process of endothelialization and also the inflammation that is there in the beginning, so at this stage (6 months for me) there would be no advantage in the newer model for me as I have passed those stages of healing. I will have one more TEE to check it in November.]]></description>
            <dc:creator>Daisy</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 03:40:28 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192958#msg-192958</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192958#msg-192958</link>
            <description><![CDATA[ I believe Daisy is right. It&#039;s just that they haven&#039;t run trials for valvular afib and they would have to do so in order to be able to claim it works for those people. Clinical trials are hugely expensive, many millions of dollars and years of work for hundreds of people. So they have to make a business decision weighing those costs against the expected market. The market of people with valvular afib is much smaller than the market for afib in general, so that&#039;s why they&#039;re not rushing into it. <br />
<br />
For more examples of this, did you know that many of the antiarrhythmic drugs used to treat afib have never been approved for afib? Flecainide is the poster child for this. It was approved in 1984 and was specifically approved only for ventricular arrhythmias, nothing atrial. It began being used for afib by doctors willing to try it off label and now it&#039;s become routine. We might see this happen with valvular afib and drugs like Eliquis eventually, but it requires doctors brave enough to use a drug off label. It&#039;s a big legal/financial risk for them.<br />
<br />
The Atriclip is applied to the outside of the heart, not the inside, so clots forming on the device aren&#039;t a concern. Any clots that did form would be irrelevant and harmless since they&#039;re outside the circulation. Since you&#039;re doing the valve surgery anyway, an Atriclip makes perfect sense for you. A Watchman makes no sense at all since it would require a second procedure. An Atriclip is also probably safer than suturing. Surgical removal and suturing can sometimes result in sutures too tight that restrict atrial wall movement. Not sure what you&#039;re talking about with suturing from the inside. That&#039;s not what they would do for you.]]></description>
            <dc:creator>Carey</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 03:17:23 +0000</pubDate>
        </item>
        <item>
            <guid>https://www.afibbers.org/forum/read.php?9,192942,192957#msg-192957</guid>
            <title>Re: Best method of LAA Closure</title>
            <link>https://www.afibbers.org/forum/read.php?9,192942,192957#msg-192957</link>
            <description><![CDATA[ <blockquote class="bbcode"><div><small>Quote<br /></small><strong>As I understand it, it isn’t that they AREN’T for valvular Afib, just that they can’t approve it unless there are trials and no one has done trials yet. I doubt if they have any suspicions that there would be a problem for valvular Afib patients.</strong><br />
</div></blockquote>
<br />
I see... It would be nice if any of those articles or videos stated exactly that. All they would have to do is state Valvular AFIB isn&#039;t approved for such and such more studies are needed and it would make sense. To just specifically state for NON-VALVULAR Afib, it leads to a lot of questions. Are<br />
you planning on getting an upgrade to the new and safer FLX Watchman when it&#039;s available?]]></description>
            <dc:creator>cornerbax</dc:creator>
            <category>AFIBBERS FORUM</category>
            <pubDate>Sun, 22 Oct 2023 02:24:43 +0000</pubDate>
        </item>
    </channel>
</rss>
