Dr. Enzo Di Giacomo, an 87-year-old retired surgeon and emergency medicine physician, was working in his garden one morning when he started to feel lightheaded.
“It actually stopped me in my tracks,” says Enzo. “I had experienced atrial flutter in the past, an abnormal heartbeat, during which the atria may contract at a rate between 200 and 400 beats per minute. Twelve years ago, I was treated and responded well. Then, somewhat similar symptoms started to develop again.”
Enzo, who once served as U.S. Air Force chief of surgery at Westover Air Force Base, says he was diagnosed with atrial fibrillation this time, another type of arrhythmia, or irregular heartbeat, that is serious because it can cause a blood clot that can lead to a stroke.
In many cases, people with atrial fibrillation, also known as Afib, don’t feel the irregularity of their heartbeat. Instead, they notice symptoms, just like Enzo did – shortness of breath, faster-than-normal pulse, lightheadedness, and sometimes chest pain.
Enzo learns about the WATCHMAN device
“We monitored my Afib for a couple of years. Dr. (Timothy) Egan at Baystate Health was the cardiologist I was seeing, and he mentioned the WATCHMAN device as something I might be interested in.”
The new WATCHMAN device procedure is an alternative to putting patients who are good candidates for it on blood-thinning medications.
“I was worried about being on a blood thinner,” says Enzo. “I worried about falling or doing something that might cause bleeding. Dr. Egan sent me to Dr. (Amir) Lotfi at Baystate. He performs the procedure, and after doing a workup on me, he suggested I do it.”
Enzo had a medical and surgical background so says he had no hesitation saying “yes” to the procedure.
“It was a much better alternative than having a stroke or being on blood thinners for the rest of my life,” he explains. “I had a lot of confidence in Dr. Lotfi.”
The WATCHMAN procedure
Late last fall, Enzo had the procedure done and says he has been fine since. The WATCHMAN device does not cure Afib, so he still gets some of the symptoms, but he says it gives him peace of mind to continue to live his life and not worry about stroke.
“I was told it takes three to six months for tissue growth over the appendage where the device is placed. Until then, I had to be careful. But now I don’t have to think about it,” he says. “You don’t feel anything, so it’s easy to forget.”
Enzo, who is married with two children and five granddaughters, says the staff at Baystate Medical Center was “excellent” and took good care of him.
He says once the device is implanted, you don’t feel anything, don’t even notice that it is there.
“It’s such an easy procedure on the patient,” Enzo says. “If you’re the first patient in the morning, you can typically go home by evening. If it’s later in the day, you stay overnight and then go home the next day. They like to observe you for a few hours.”
He says other than a few tests, like bloodwork and an echocardiogram, there is not a lot of preparation for the procedure.
“I’ve gotten back outside to garden and do some outside work and it feels good,” he says. “I did this when I was 86 years old, and I don’t have any regrets. The greatest thing about it is that the fear is gone.”
Dr. Lotfi explains more about the WATCHMAN
Dr. Lotfi, MD, FRCPC FSCAI, Chief, Cardiology Division Baystate Health, Associate Professor of Medicine, UMass School of Medicine, explains that one of the major concerns with atrial fibrillation is stroke caused by a blood clot and this procedure all but eliminates that concern.
He says blood thinners can reduce the risk of stroke caused by a blood clot but can also limit a patient’s activities. Sometimes when placed on a blood thinner, a patient will have bleeding problems, like gastro or taking frequent falls. Many are active but feel the need to stop hobbies like riding a horse or skiing.
The WATCHMAN device is a good alternative for some, he says. The Federal Drug Administration approved the device in 2015. Baystate Health has since performed 300+ WATCHMAN procedures, with Dr. Lotfi performing more than 100 of those.
Dr. Lotfi explains that the WATCHMAN device, also known as the left appendage closure, is implanted in a pouch located in the top left chamber of the heart, the left atrial appendage, where 90 percent of clots form. It is designed to seal off that pouch so a clot can’t form. If all goes well, people like Dr. Enzo Di Giacomo come off their blood thinners within months of the procedure. The device is about the size of a quarter and is implanted during a minimally invasive surgery. Once implanted, it lowers your lifetime risk for stroke, without blood thinners.
Patients that have AFib not caused by a heart valve problem might be a good candidate for the WATCHMAN device and procedure if they also:
- Have a history of serious bleeding while taking blood thinners.
- Have a lifestyle, occupation, or condition that puts you at risk for serious bleeding.
- Are having trouble with your warfarin treatment plan and a different type of blood thinner is not an option.
If you have Afib, reach out to our team about the WATCHMAN device and procedure to see if it’s right for you.