is Watchman necessary?

Can someone explain to me re having a Watchman? My cardiologist has never mentioned it but someone I know said I should have it to prevent a stroke (I am on Eliquis but I realize that does not always prevent one). Now I am concerned about this

First off, never mind this someone you know. I don't think they know much about the subject. If you're on Eliquis and taking it reliably as directed, you're about as well protected from stroke as you can be, so you can relax about that.

The Watchman was originally developed for people who can't tolerate anticoagulants like Eliquis. It was only a few years ago that if you could tolerate any anticoagulant, you simply weren't eligible for a Watchman. But as time went by and the Watchman became more commonly used, other benefits were recognized. For example, it doesn't increase bleed risk like anticoagulants do, and it eliminates the ongoing cost of anticoagulants, which can be substantial. Also, there are patients (like me and others here) who are at high risk of stroke by missing even one or two doses because we've had our LAAs isolated (most people haven't). And most importantly, it eliminates the problem of non-compliance of patients with their anticoagulants, and the stats on that are pretty dismaying. Upwards of 40% of people taking them eventually stop or become sporadic and unreliable about it.

So slowly but surely insurance companies, Medicare, and non-US public health services started to recognize the benefits and most of them have now come around to covering them if their doctor recommends it.

So talk to your doc about it if it concerns you, but you have no reason to feel you need one.

I'd like a clarification on what you wrote above:

Quote
Cary
Also, there are patients (like me and others here) who are at high risk of stroke by missing even one or two doses because we've had our LAAs isolated

Are you saying that patients who have had their LAA isolated (clipped or ligated) are at an inherently higher risk of stroke as compared to patients who have not had their LAA isolated?

By "isolated" I mean electrically isolated by ablation. People who've had their LAAs ligated, clipped, or surgically removed have nothing to worry about. And what I said only applies to some people who've had their LAA isolated. If your LAA continues to pump adequately after isolation, you don't face additional risk. But if it doesn't (as mine didn't), you are at heightened risk of stroke and face a lifetime of never missing a single dose of anticoagulants. As you can imagine, that's a tall order. So for patients like me, a Watchman makes sense.

If on needs surgery or a colonoscopy as examples, having a watchman is beneficial because one can go off Eliquis for up to 5 days (according to Dr Natale) without additional risk of stroke from having their LAA isolated or being in AF.

Also for my situation, I convinced the ER doctors to ECV more easily by having my watchman.

It’s a personal choice. Once having a watchman I was able to reduce my Eliquis dose 50%. However a watchman will not help DVT and I recently got my second DVT and my Hemotologist put me back on 5mg BID for life because Eliquis and my watchman didn’t reduce the 2cm clot at 2.5mg BID.

I will say get the best EP for a watchman procedure. A random EP once stopped by my room trying to sell me in getting it. I asked if he had complications. He said he ripped three patients. Honest guy. I later heard he isn’t allowed to insert watchman’s anymore.

I had Dr Natale perform it. He is simply a master. My femoral vein had a sharp curve and he tried for 20 minutes before successfully getting it pass without damage. Then my LAA had an unusual shoulder that was curved and he performed magic. He then did 2 TEEs until he was confident I had no leaks.

Very recently I got an email from his office to get a 2 year Imaging. I think a CT? I never had imaging since my 6 month procedure and being on Eliquis 5mg BID doesn’t motivate me

I recently had a CT with contrast to check if my lungs were free of DVT clots but I was unsuccessful in convincing anyone to check my LAA which is frustrating.

I recommend a watchman if you had your LAA isolated. It’s an easy procedure. I went home 3 hours later.

Thanks Cary,
OK, glad we have a common understanding of "isolated". (I hope you can understand why I found that confusing)

thnx for info