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My dad at Age 100 had 20 some years earlier had a CABG surgery and was going strong...but one day he didn't feel too great and wanted me to make an MD appt. Due to a cancellation he was able to be seen the next day....and his heart rate was 35. He was they said in heartblock, and was taken to the nearest hospital where the next day they put a pacemaker in. But what they didn't educate us about prior was that while he was quite stable at 35 BPM, they could not risk adequate anesthesia for fear they would lose him...so his memory holds this experience which turned out to be quite traumatic...being virtually wide awake while they slashed his chest open to put it in. Had we known, I don't know what we would have done. THis IS a reputable facility and the MD was quite well regarded....we might have found another MD for a 2nd opinion. My dad being my dad, the procedure was done about noon and at 2 PM he was back in his room eating a sandwich. Just beware...
If it was my husband, I would opt for the device so he could get off the blood thinners - and all the associated risks with being on blood thinners long term.
Specialists also tell patients that they must continue a certain medication every day or they will have another stroke/heart attack.
If you are both looking at quality of life, then more procedures may not be the way to go.
You know him best, and you know what you can manage. Please dont let anyone, MDs included, try to make you feel that you are being neglectful by declining treatment for him. Good luck.
Given that he had one episode of over anti-coagulation b/c a PCP ignored the med list I gave and prescribed a med that caused anti-coagulation, we were both leary about trying something that didn't require regular monitoring of PT/INR levels.
Boston Scientific makes it; I believe it was the maker of my father's pacer as well.
You might want to check with his previous cardiologist, unless there were negative reasons for switching to the new doctor.
I did a quick check for class action lawsuits, adverse actions, etc. and found this 2019 article on side effects and negative aspects. It is of interest, and I would consider it seriously, perhaps doing more research.
https://www.nationalinjuryhelp.com/watchman-stroke-device-lawsuit/
There were negative reasons we changed. I wouldn't ask his old doctor for the time of day. To be honest about half of my problems was with the office staff.
I'm not making a judgement here, but just suggesting you look at all the angles. Just because the treatment is there doesn't always mean it's the best treatment for the best outcome.
I'm familiar with it. Here's a video from the makers of the device
https://youtu.be/Gt5Sz8FR7JM
The data on the procedure so far looks fairly good (https://www.tctmd.com/news/low-1-year-stroke-risk-after-commercial-watchman-use)
Post procedure there is still a need for some type of blood thinners for the first 30-45 days or so while the device settles in-once a good seal is confirmed by a follow-up echocardiogram they will decide what meds they want to continue for up to 6 months, usually something like aspirin, plavix, or eliquis.
The places I am familiar with use an anesthesiologist for these procedures, since they confirm the position of the device with an echocardiogram probe that the patient swallows. That requires more sedation than for something like an angiogram. For an angiogram, the patient is relaxed, or awakens to verbal stimuli, for an LAAO procedure your husband would be soundly asleep, but still breathing on his own-not intubated. You might want to confirm with the cardiologist what their practice is at their facility and discuss concerns about sedation sequelae. Good luck!
https://www.watchman.com/en-us/how-watchman-device-works.html
My DH had a pacemaker installed in 2019 under local anesthetic and he felt no pain during the procedure or afterward, and the PM has kept him alive, literally.
On the other hand, my 94.5 y/o mother has AFIB and was on blood thinners for 7 years; they began causing her more harm than good when she started developing the worst nosebleeds the ER doc had ever seen. The last of the 4 she had, I arrived in the ER to see the doctor photographing the clot that came out of her nose which was the size of a plum. He was going to post it on the bulletin board for the whole staff to see. I got mom off of Xarelto the next day. She did have a mild stroke the CT Scan said some time afterward, so there's that. She also has moderately advanced dementia nowadays and no lifesaving measures are being taken b/c her quality of life is very compromised at this point.
Wishing you and DH the best of luck with your decision.