Watchman

Headed to Austin next week for a Watchman procedure on June 19th. Had an ablation for flutter on March 11, and at that time Natale told me he now implants a Watchman on all ablations.....but does not do it in one procedure....usually three months later.

Hopefully will be able to get off the Xerelto some time afterwards. Fortunately, my local EP cardiologist steered me onto a Canadian pharmacy and able to get 84 days of Xerelto for $175.


Steve
Klein, Tx.

I had not heard of this before.
What is the rationale for the change in his policy?
Are there studies done that encourage this?
Why the new ‘watchman’ with every ablation?
Thanks!

A Watchman provides comparable or superior stroke protection
No bleed risk
No daily meds
No interactions or side effects
Impossible to forget a dose, lose your meds, etc.
In the long run, lower cost

Thanks, Carey!
Although I thought they still recommended daily baby aspirin with Watchman. Do you know if that is still the case?

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allofus
Thanks, Carey!
Although I thought they still recommended daily baby aspirin with Watchman. Do you know if that is still the case?

Depends on who you talk to--that was never Natale's protocol. He preferred a half dose of Eliquis--at least until you had passed a couple of checkups with flying colors. He did my Watchman and I choose (with his blessing) to remain on a half-dose of Eliquis to deal with the potential of the 10% of blood clots NOT generated by the LAA.

Yes a baby asprin a day for life post Watchman is still the official recommendation but that is evolving and studies are looking at if that is necessary. My EP put in a Watchman at the time of ablation recently. His post implant regimen goes to a baby asprin every other day after 3 months.

I think the elderly/seniors, especially those who cannot be, or who choose not to be, mobile several times each day, should be on some kind of clotting control. I sit at the computer for hours each day to keep my brain occupied, but also because I love to learn (I'll never claim to be a quick study, but I plug away at it, almost incessantly). I'm grateful to be on apixaban, and have resigned myself to it for the duration. I have had no detectable ectopy for over two years, but AF or PACs could start up again any time.

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allofus
Although I thought they still recommended daily baby aspirin with Watchman. Do you know if that is still the case?

That's still the FDA's recommendation, but when the FDA approves drugs or devices, they rarely change their approval later. That's why, for example, flecainide still isn't approved for use with afib even though that's its most common use and has been for years.

It's also helpful to keep in mind that Europe has no such recommendation and never has. It's mainly just the FDA being overly cautious with a new device and then not updating recommendations later when it's no longer new.

What Daisy described is 100% my situation as well. Natale gave me the same advice and I chose to continue the 1/2 dose Eliquis indefinitely for the same reason Daisy did.

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Carey

What Daisy described is 100% my situation as well. Natale gave me the same advice and I chose to continue the 1/2 dose Eliquis indefinitely for the same reason Daisy did.

I got the same advice. I’m back on 5mg bid after my watchman because I developed a dvt while on 2.5 bid.

.5mg bid Eliquis is not a hard and fast Natale recommendation. He switched me from .5 bid to a daily low dose aspirin about a year after the Watchman implant. It wasn't advice or a recommendation really, more of a this is what I want you to do going forth.

A year ago, I had a bilateral pulmonary embolism (no source found) and started Eliquis and it cleared up. No afib since my last ablation, but the Dr. said it would be wise to stay on Eliquis forever. I wonder if a half dose would work? I bruise easily but haven't had any bleeding issues even with minor surgeries. I haven't thought of or considered a watchman.

I don't know, Ken, but if I'd experienced a PE of unknown cause, I'd stay on full-dose Eliquis forever. A Watchman wouldn't help you prevent that since PEs are caused by clots in the venous circulation, not arterial, and the Watchman can only prevent clots in the arterial circulation.

I got my second DVT clot in my venous circulation located in my armpit on my right side. After reading this site’s suggestions not to sleep on one’s left side, I always wondered if I developed my second dvt while on 2,5mg eliquis because I slept with my shoulder pinning down my arm-thus not giving it enough circulation. My first DVT occurred after a 17 hour flight sitting in a tight seat without much leg movement.