When Michael Wessel traveled from Pittsfield to Baystate Medical Center recently for a minor heart procedure, he became somewhat of a celebrity.
The Berkshire man was the 100th patient at Baystate – the only hospital in western Massachusetts to offer the procedure – to receive the implantable WATCHMAN device.
“Thanks to a wonderfully talented team who is committed to providing access to high-quality care at Baystate, we were able to bring this unique WATCHMAN device to the region for a special group of patients whose options are limited in treating their atrial fibrillation,” said Dr. Amir Lotfi, associate chief, Division of Cardiology, Baystate Health.
It Began with Fender Benders
One of those “special” patients, Wessel was having some fender benders and didn’t realize what was happening to him, that he was losing consciousness behind the wheel.
“I was having these minor accidents and couldn’t figure out why,” said Wessel.
“My doctor had me wear a heart monitor for a month and that is when it was determined that I had atrial fibrillation,” he added.
Atrial fibrillation, often called AFib or AF, is the most common type of heart arrhythmia. An arrythmia is when the heart beats too slowly, too fast, or in an irregular way. As a result, some may experience lightheadedness, extreme fatigue, shortness of breath, or chest pain.
What is AFib?
In AFib, the upper heart chambers quiver and shake and do not contract, or squeeze, as they should. Because blood isn’t pumped out of the heart normally, it’s easier for blood cells to stick together and form clots in an area of the heart called the left atrial appendage (LAA).
In people with atrial fibrillation not caused by a heart valve problem (also called non-valvular AFib), more than 90% of stroke-causing clots that come from the heart are formed in the left atrial appendage. When a blood clot escapes from the left atrial appendage and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.
AFib is often treated by medicines to control the heart’s rhythm and rate, as well as blood-thinning medicine (anticoagulants) to prevent blood clots from forming and reduce stroke risk.
Blood Thinners Are Not for Everyone
However, not every patient can tolerate blood thinning medication known as warfarin (Coumadin), which can cause bleeding due to excessive anticoagulation - the most serious of bleeds occurring in the gastrointestinal track or brain leading to a possible stroke.
“It (warfarin) wasn’t right for me and my primary care doctor took me off of the blood thinner because I was experiencing bleeding issues,” said Wessel, who moved from England to the United States in 1991.
“With my increased risk of stroke now that I was off of the blood thinner, my cardiologist in Pittsfield told me about the WATCHMAN procedure offered at Baystate Medical Center that could help me,” he added about the hospital’s efforts to ensure patients in western Massachusetts have access to the most advanced of procedures.
Until the advent of WATCHMAN, there were no other therapies available to help prevent stroke for patients who could not tolerate taking long-term anticoagulation medicine because of the increased risk of bleeding, for example, if someone were to fall and injure themselves.
Proven to Reduce Stroke Risk
WATCHMAN is an implantable device made by Boston Scientific, which is proven to reduce the risk of stroke in patients like Wessel with AFib not caused by a heart valve problem. It works differently from blood thinners like warfarin and is a permanent implantable device – the only one of its kind approved by the FDA – that closes off a part of the heart where blood clots commonly form and keeps them from escaping.
“I was given a preliminary exam at Baystate by Dr. Lotfi to make sure I was a right fit for the WATCHMAN, and luckily I was. I found Dr. Lotfi to be extremely pleasant and outgoing, who was very forthcoming about the procedure and what I would be going through. I trusted him from the beginning,” said Wessel.
The WATCHMAN procedure is performed by an electrophysiologist, such as Baystate’s Dr. Marshal Fox, or an interventional cardiologist like Dr. Lotfi in Baystate’s Electrophysiology (EP) Lab, along with Sean Lavalley, RN, nurse coordinator for the WATCHMAN program, who is an instrumental part of the WATCHMAN team. Drs. Lotfi and Fox performed the first WATCHMAN implant at Baystate in 2018.
The Size of a Quarter
The WATCHMAN device, about the size of a quarter, doesn’t require open-heart surgery. Instead, doctors make a small cut in the patient’s upper leg, then insert a narrow tube through which the WATCHMAN is guided into the left atrial appendage. The procedure is performed under general anesthesia and requires an overnight stay. Patients are usually discharged the following day and have a scheduled follow-up in 45 days to evaluate the device’s performance.
After the procedure, patients take warfarin until their LAA is permanently closed off, usually in about 45 days. During that time, heart tissue grows over the WATCHMAN implant to form a barrier against blood clots.
In addition to reducing the risk of stroke, WATCHMAN has other benefits for AFib patients, including the elimination of regular blood tests and food and drink restrictions that come with warfarin.
One of Few Centers
Dr. Lotfi noted there continue to be advancements in procedural techniques and improvement of the device.
“We were one of the few centers to obtain the new version of the WATCHMAN device called WATCHMAN FLX, which allows for a greater number of patients to be eligible for the procedure,” said Dr. Lotfi.
“Our introduction of WATCHMAN for area patients is another example of how Baystate continues to provide leading-edge technology in order to enhance their lives and that of their families. The procedure is important, but the most rewarding part for me is ensuring that my patients like Michael can go out and enjoy their life,” he added.
For Wessel at age 83 years young, that means cutting the lawn in the summer and snow blowing in the winter.
“But one thing I won’t be doing any longer is driving,” he said.
Learn more about the Baystate Heart & Vascular Program.