Atrial fibrillation is one of the most common heart rhythm abnormalities. With this condition, the heart's upper chambers (the left and right atrium), have disorganized electrical activity. Because of this, they also have disorganized mechanical activity, meaning that they don't squeeze properly. As a result, the blood flow in those chambers slows down and that slow flow can allow a clot to form. That clot can then exit the heart and go to other parts of the body, including the head where it can cause a stroke. As a result, many patients with atrial fibrillation are placed on a blood thinner to prevent this from happening. However, for a variety of reasons, some patients may not be able to take a blood thinner long term. For those patients, a Watchman device may be a good option.
With atrial fibrillation, most blood clots tend to form in a specific region of the heart, an area called the left atrial appendage. The Watchman is a device placed at the opening of the left atrial appendage, and is used to seal off the appendage from the rest of the heart, so that clots that form in the appendage cannot travel outside of it. The device is placed via a catheter inserted in the leg. Ultrasound and X-ray guidance are used to make sure the device is placed correctly. Patients who get the Watchman device still need to be on a blood thinner for several months after the procedure, but will not need to take it long term.
At Virginia Heart our cardiac electrophysiologists implant and monitor devices that either help the heart’s electrical system function properly or measure heart rhythm. These devices include pacemakers, implantable cardioverter defibrillators (ICDs), and implanted heart rhythm monitors called loop recorders.
Implantable Cardioverter Defibrillator, or ICD, shocks the heart’s rhythm back to normal.
A device implanted under the skin of the chest and connected to wires that go into the heart. Its used to automatically deliver a series of pacing pulses or an electrical shock to the heart to correct a potentially life-threatening rapid heart rhythm. .
The ICD device is surgically implanted in the chest wall below the collarbone. Surgery typically takes about an hour and requires an overnight stay in the hospital. Your doctor may restrict your activity, including driving and lifting items heavier than 10 pounds, until your follow-up appointment 2 weeks after surgery.
Pacemaker is a small device that’s implanted under the skin of the chest and connected to wires that go into the heart. It produces electrical pulses to keep the heart beating at a normal rate. A pacemaker helps correct an abnormally slow heart rhythm.
A pacemaker is implanted in the chest, beneath the collarbone during a procedure that requires local anesthesia and sedation. The surgery typically takes less than an hour to complete and usually requires an overnight stay in the hospital.
You can most likely return to your usual activities the day after pacemaker implantation, but your doctor may restrict some activities for two weeks. Restrictions include temporarily avoiding lifting anything heavier than 10 pounds and not engaging in exercises—such as swimming, golf, or tennis—that strain the affected side.
Biventricular Pacemaker works like a conventional pacemaker, but uses an additional wire to send electrical impulses to the heart to ensure that both lower chambers of the heart contract at the same time.
Doctors provide local anesthesia and a sedative when implanting a biventricular pacemaker. The surgery takes about two hours to complete and requires an overnight stay in the hospital. The restrictions afterward are the same as those recommended after the implantation of a conventional pacemaker.
Implantable Cardiac Loop Recorder continuously records your heart’s rhythm for up to three years. People who have had unexplained fainting spells or heart palpitations that can’t be detected by short term heart rhythm recording devices—such as Holter monitors—may be candidates for this device.
Smaller than the size of an AAA battery, this device is surgically inserted beneath the skin of the upper chest to record the heart’s electrical activity, much like an electrocardiogram, or EKG. Your doctor makes a small incision in the upper chest and inserts the device just under the skin. The surgery is brief, and you can return to your usual activities the next day. Your doctor may limit your activity until the incision heals.
The Watchman is a device placed at the opening of the left atrial appendage, and is used to seal off the appendage from the rest of the heart, so that clots that form in the appendage cannot travel outside of it. The device is placed via a catheter inserted in the leg. Ultrasound and X-ray guidance are used to make sure the device is placed correctly. Patients who get the Watchman device still need to be on a blood thinner for several months after the procedure, but will not need to take it long term.
