Ascension Providence now offers an alternative treatment for patients with atrial fibrillation who must take blood thinners to reduce their risk of stroke.
It is the first use of technology of its kind in Waco, Ascension Providence officials said.
In conjunction with Waco Cardiology Associates, Ascension Providence expanded its Structural Heart Program to offer this procedure, called Watchman. Ascension recently invested $6 million upgrading its catheterization laboratory, part of the expanded program.
“The procedure itself is used to address folks with atrial fibrillation. Atrial fibrillation is a rapid rate of contraction of the upper chamber of the heart,” said Dr. Brian Becker, Ascension Providence chief medical officer. “That incomplete contraction of the top part of the heart can reduce the ability for the heart to empty all the blood in that chamber. This particular component closes off the area where blood can collect and clot.”
Becker said people with atrial fibrillation often are placed on blood thinners to prevent blood from clotting in the area the new procedure addresses. Clots can travel from the heart to the head and cause a stroke.
Waco Cardiology Associates make a small cut in the upper leg or groin area and inserts a catheter, or flexible tube, into a vein. Then they introduce the Watchman device into the vein and transport it into the heart with the catheter, where it is placed into the “outpouching” of the left atrial appendage, where clotting could occur, Becker said. The device or implant varies in size, depending on the patient’s ultrasound.
In time, heart cells grow over the implant, sealing off the appendage and preventing blood from collecting there and clotting. After 45 days, patients can stop taking blood thinners, like warfarin, if an ultrasound shows the appendage is blocked, Becker said.
“Some patients don’t do well on blood thinners,” Becker said. “Others can be on a medication that counteracts that blood thinner so that it’s not effective. Some folks have a job that prohibits them being on a blood thinner. Those would be physical jobs where they may bump or bruise themselves.”
Internal bleeding also is a risk for patients on blood thinners, he said. The cost of blood thinners is a factor, as well, because some patients must take them for the rest of their lives.
“Studies have shown that with the placement of this device in about two years it’s paid for itself just in the cost of medicine,” he said.
The Watchman procedure has been available since 2015, and more than 50,000 devices have been implanted in patients, Becker said. Typically, patients stay in the hospital overnight after the hourlong procedure, and 99 percent of them stop taking blood thinners within a year of the surgery. It is Medicare-approved.
“Our goal here at Ascension Providence is to try to provide all the services that we can locally,” Becker said. “Oftentimes, that means going to Dallas or Houston or Austin or San Antonio to get specialized procedures done. That is a huge inconvenience to patients. If it’s something we can safely bring into our facility and give to our community — that access point for procedures or testing — that’s vitally important for us in Waco to be able to provide for those folks not only in Waco but in our surrounding communities, as well.”
Baylor Scott & White in Temple also offers the service, according to the Watchman website.