Still Negative on Watchman

Many readers have contacted me to ask whether my negative viewson left atrial appendage occlusion with Watchman have changed since 2017.   The short answer is no. My views are even more negative today.  In 2016, I published an editorial on theHeart.org | Medscape Cardiology arguing that this procedure should stop. One of the rebuttals was that it was a blog post, not an academic editorial. Months later, Andrew Foy, Gerald Naccarelli and I put the same argument into academic-speak and the influential journal Heart Rhythm published it.[1] I have debated and presented this topic multiple times in the US and Europe.  The newest data on Watchman have reinforced my negative view. Efficacy Issues:  Two studies published in 2018, one from Watchman investigators,[2]and the other from independent French researchers,[3] found high rates of device-related thrombus on follow-up echocardiograms (Translation: clot stuck to the device). This is not surprising since the Watchman is a foreign body left in the heart. This data also helps explain why, in the Watchman vs warfarin trials, ischemic stroke (due to blockages) rates were HIGHER in the watchman arm.  Both these papers reported that clots on the device go away with clot-blocking drugs called anticoagulants. That’s an existential problem because the main reason for having the device put in is to avoid the need for anticoagulation.  Procedural Complications Higher After Approval:  ...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs