Understanding Atrial Fibrillation

Also called AFib, atrial fibrillation is an irregular heartbeat (arrhythmia) that can lead to serious heart-related complications. The most common type of atrial fibrillation is non-valvular, meaning it is not caused by heart valve problems.

During atrial fibrillation, the upper chamber of the heart is quivering rather than effectively pumping blood into the ventricles, which causes blood to collect and clot. As the clots form, they often collect in a structure called the left atrial appendage, or LAA. If a blood clot escapes from the LAA and reaches the brain, it can cause a stroke.

For the estimated five million Americans affected by atrial fibrillation, the most common method for preventing stroke is anticoagulants, or blood thinners. Unfortunately, long-term use of anticoagulants carries risk for complications and is not always well-tolerated by patients.


An implant the size of a quarter, WATCHMAN is a device designed to reduce the risk for stroke in non-valvular atrial fibrillation patients in place of anticoagulants. WATCHMAN fits precisely into the LAA so that blood clots cannot escape and cause a stroke.

How It Works

The implantation of WATCHMAN is a one-time procedure. To insert WATCHMAN, your doctor will create a small incision in your upper leg, using a narrow wire to guide the implant into the LAA. The procedure, which is done under general anesthesia, is typically completed in less than an hour.

Following the procedure, you will remain on your anticoagulants until the LAA is completely shut off, which takes about 45 days. During that period, heart tissue grows over the implant to create a barrier against blood clots.

Benefits of WATCHMAN

Since more than 90% of the stroke-causing clots in the heart form in the LAA, closing off access to the area significantly reduces a patient’s risk of stroke. Beyond that, WATCHMAN’s ability to replace anticoagulants is substantial – nearly half of all patients eligible for anticoagulant medication remain untreated due to intolerance or issues with adherence. WATCHMAN can be an effective replacement therapy. HS

Dr. kelly richardson cardiologist chattanooga heart institute at CHI memorial expert opinion on watchman device

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