Left Atrial Appendage (LAA) Closure WATCHMAN™ Device or Amplatzer™ Amulet™

What is the purpose of a left atrial appendage closure?

Patients with atrial fibrillation (AF) have a high risk of developing blood clots in the heart that could cause a stroke. Most of these clots form in a small outpouching called the left atrial appendage (LAA).

Two FDA approved options to reduce the risk of stroke from AF include:

• Oral anticoagulation with drugs such as Warfarin (Coumadin), Rivaroxaban (Xarelto) or Apixaban (Eliquis)
• Closure of the LAA via a minimally invasive procedure (i.e., WATCHMAN™ device)

The WATCHMAN™ device is a one-time implant for patients with AF who need an alternative to long-term anticoagulation (blood thinner) use.

How is the LAA Closure device implanted?

On the day of the procedure, the anesthesia team will administer medications to make you go to sleep. Your doctor will insert a small, flexible tube called a catheter through one of the leg veins in your groin. Your doctor will then guide the device through the catheter and into your LAA.

The procedure typically takes about an hour. People who get a LAA Closure device may go home on the same day or stay one night in the hospital based on your individual condition and discussion with your doctor.

How safe is the procedure?

The devices have a low risk of complications, however, like with all procedures, there are some risks involved. These risks will be discussed with your doctor prior to the procedure.

When should a LAA Closure device be discussed?

There are many criteria (like history of bleeding, risk of falling or not tolerating blood thinners) that are looked at before deciding to implant. You will have a visit with one of the doctors that performs this procedure to discuss your individual risks and benefits.

Your doctor may also recommend additional images of your heart via a CT scan or transesophageal echo (TEE) prior to the procedure to assess your candidacy for the implant.

Can I stop my blood thinners immediately after the LAA Closure implant?

You will usually take a full blood thinner and aspirin for the first 45 days after the implant. During this time, your heart tissue grows over the WATCHMAN™ or Amplatzer™ Amulet™ device to form a barrier against the blood clots. Your individual blood thinner regimen may be modified based on your individual situation and discussion with your doctor.

You will have a scan of your heart via a CT or TEE at 4-6 weeks from implant to confirm that the barrier has been formed before stopping the full blood thinners. You will then use a regimen of aspirin and Plavix for 4.5 months and then take aspirin for the rest of your life.