MUSC Health Columbia Medical Center Downtown helps hundreds get off blood thinners with WATCHMAN

Doctors at MUSC Health Columbia Medical Center Downtown have implanted their 800^th WATCHMAN, a device that can prevent strokes in patients with an irregular heart rhythm known as atrial fibrillation.

The milestone is cause for celebration, said L. Garrison Morgan, M.D. He directs the Structural Heart Disease program and serves as associate director of the Claude W. Smith School of Cardiovascular Technology at MUSC Health in Columbia.

“We are a high-volume center that does exceptionally good work, and we have very good outcomes. The more of these procedures that you do, the better you are. We're to the point now where we can put the entire device in in about 15 minutes. And patients only have to be on bed rest for about two hours, and they can go home,” Morgan said.

 

He explained what happens in people with atrial fibrillation, or A-fib. “The problem is the underlying rhythm in the patient's heart called atrial fibrillation. It makes the top chambers of the heart quiver instead of contracting to push the blood around in that top chamber. It just so happens that this top chamber on the left side of the heart, the side that pumps to the brain, has a small pocket called the left atrial appendage. It forms an eddy where the fluid kind of just swirls around, and it can make a blood clot. And 90% of all strokes that happen in patients that have atrial fibrillation originate from a blood clot in that little appendage.”

For years, blood thinners were the go-to to prevent those clots. Blood thinners are really good at preventing clots that cause strokes, but they're also really good at preventing clots that stop bleeding. And so they make patients bleed easily, which can be a problem for patients who are unsteady and frequently fall or have a history of bleeding problems, Morgan explained.

The WATCHMAN solves that issue, he said. It’s basically a small plug. “It sits in the opening of that little pocket on that top chamber of the heart, and it seals off that pocket forever. So there's no pocket. There's nowhere for a blood clot to form. And if there's nowhere for a blood clot to form, there's no reason for them to be on a blood thinner. So that little device gives them stroke prevention, just like their blood thinner would, for the rest of their lives, and they never take another blood thinner ever again.”

He said the WATCHMAN is going from being a mainstream procedure to becoming, hopefully, the gold standard for atrial fibrillation. “There are clinical trials that we were part of that are finishing up right now that are essentially giving patients the option of having a WATCHMAN device as first-line therapy. It's very safe. It's effective. It's quick. And it gives the patient a lifetime worth of stroke prevention from one simple procedure.”

Morgan said there are risks associated with any heart procedure, and patients should speak with their doctors about those risks and compare them with the benefits of coming off blood thinners. But he also said the risk of a complication from an appendage close procedure is “exceedingly rare.”

In his experience, procedures to implant Watchmen usually go extremely smoothly. “In fact, over the last six years, we’ve had a 99.5% success rate for implants and no major complications at all.”

What’s next? His team has a new goal with a deadline of next summer. “We want to be the first program in South Carolina to do 1,000 implants.”