“When the pulse is irregular and tremulous and the beats occur at intervals, then the impulse of life fades.” – The Yellow Emperor
Atrial fibrillation (AFib) is the most common abnormal heart rhythm found in the community. As per CDC website, an estimated 12 million people in the United States will have atrial fibrillation.
Your heart has a rhythm, like a drum keeping time for your body. But sometimes that drum loses its beat – that’s atrial fibrillation, or AFib for short.
Think of your heart as a two-story pump. The top floor (the atria) should work synchronously with the bottom floor (the ventricles) every single beat. With AFib, the top floor goes haywire, beating like a jazz drummer who’s had too much coffee. This chaos means blood doesn’t flow properly, and that’s where things get risky. Sluggish blood can form clots, and if those clots travel to your brain, you’ve got a stroke on your hands.
Here’s the scary part: You might have AFib right now and not even know it. About 40% of people with AFib feel completely normal. For some unlucky folks, their first hint of AFib is a stroke – that happens to about one in five patients. Most of them are diagnosed coincidentally during a routine visit to their primary care physician or while performing an electrocardiogram (ECG) before a surgical procedure.
When symptoms do show up, they’re hard to ignore: your heart races and skips beats, you might feel dizzy, short of breath, or so tired you can barely climb a flight of stairs.
AFib is one of the most fascinating puzzles of medicine. The quest to understand AFib has sparked much scientific research, with physician researchers uncovering new clues about why our heart sometimes marches to their irregular beat. The most important task was to prevent strokes with atrial fibrillation, and then blood thinner was discovered.
It all started in 1933 with a desperate farmer named Ed Carlson, a dead cow, and a milk jug full of blood. He drove 200 miles through a blizzard to find help, stumbling into University of Wisconsin lab at Madison where researchers discovered that moldy hay was preventing blood from clotting. This discovery eventually led to warfarin – yes, the same stuff used in rat poison. It became the go-to blood thinner, especially after President Eisenhower took it in 1955.
Warfarin sodium was approved for human use in 1954 and went on the market under the brand name Coumadin. It soon became both the most widely used rat poison and the most widely prescribed blood thinner in the world.
These days, we’ve got newer options like Pradaxa, Xarelto, and Eliquis. But they all share one big drawback: bleeding risks. Despite all the new advances, all blood thinners pose one possible and severe side effect: bleeding. Since blood thinners slow the clotting of blood, unwanted and sometimes dangerous bleeding can occur especially bleeding in the brain, gastrointestinal tract, bladder etc.
Minor bleeding episodes can seriously impact on a person’s day-to-day quality of life especially with prolonged bleeding from minor cuts, shaving, bruises, node bleeding etc.
Taking blood thinners also impacts lifestyle as individual has to be careful with fall, high risk sports, physician injury, working with tools.
Until 2016, people diagnosed with atrial fibrillation had no alternatives other than taking blood thinners to prevent stroke. But there’s hope! In 2016, the FDA approved a device called WATCHMAN. Picture a tiny parachute, about the size of a quarter. Doctors can place it in a small pocket (left atrial appendage) of your heart where most clots form. The Watchman Device can fit right into the appendage and prevent blood clots from forming and escaping. For people who’ve struggled with blood thinners’ side effects, this invention is a game-changer.
The WATCHMAN Implant is a safe, minimally invasive, one-time implant that reduces your stroke risk without the need for lifelong blood thinners.
Let’s break down what you need to know before your WATCHMAN procedure.
Your physician will review the procedure in detail, including the risks. You might be asked to pause some medications for a short time. Just be sure to tell your care team about everything you’re taking.
The night before, you’ll need to stop eating and drinking after midnight (think Cinderella, but with food). Since you’ll be sleeping through the procedure, you’ll also need to arrange a ride home – this is not a time to try and catch an Uber by yourself.
What Happens During the Procedure?
The whole thing typically takes less than an hour, and you’ll be comfortable asleep the entire time. The physician will make a tiny cut in your groin area and thread a small tube up to your heart. Using X-ray and ultrasound to see where they’re going, they’ll guide the WATCHMAN device right where it needs to be in your heart. Once it’s perfectly placed, they’ll remove the tube and close that small cut.
The physician will decide if you will stay overnight or go home on the same day.
The Watchman Device is the most used, though the FDA has approved other similar devices.
The Watchman Device won’t fix your irregular heartbeat (atrial fibrillation), it does something just as important – it helps prevent strokes and lets you stop taking blood thinners for life.
You might still experience an irregular heartbeat, so you’ll need to keep working with your physician on treating that separately. Your physician will create a personalized plan to manage your atrial fibrillation and help you stay healthy.
Your heart has a rhythm of its own – until AFib crashes the party like an unwanted guest. Twenty years ago, doctors were mostly playing defense against AFib. Now, they’re armed with a whole arsenal of treatments that would’ve seemed like science fiction back then. From specific medications to ablations that fix the abnormal electrical system in your heart, we’re finally getting the upper hand on this tricky troublemaker.
