While Atrial Fibrillation or Afib can be a debilitating condition in certain patients, the significantly increased risk of stroke most immediately concerns an electrophysiologist. Most of the initial medical interventions for Afib address the issue of stroke.
Atrial fibrillation can cause blood to pool in the Left Atrial Appendage or LAA. This is a small offshoot of the heart that has no apparent use – much like the appendix in the abdomen. When blood pools in the LAA, the risk of clotting increases. When a piece of clot detaches, it can travel to the brain, blocking essential blood vessels and ultimately causing a stroke.
As tech companies dig deeper into the healthcare space, consumers can extract more and more data without lifting a finger. A few years ago, measuring heart rate on the go was a big deal. Recently, with Apple announcing that the FDA has cleared their latest watches as a medical device – an EKG – we have unique opportunities and some challenges.
In the spirit of treating significant potential risk with minimally invasive solutions, electrophysiologists now have the option to use a clever medical device to seal the left atrial appendage or LAA. This device, known as the Watchman, looks much like a parachute connected to a bio-compatible metal lattice. The Watchman fits snugly over the opening to the LAA and, over time, creates a strong barrier between the LAA and the rest of the left atrium. Doing so seals off blood clots within the LAA permanently.
How Is the Watchman Placed?
Your electrophysiologist places the Watchman in an electrophysiology or EP lab. This is a special operating room set up for catheter-specific arrhythmia procedures. The patient is sedated, and a small incision is made in the arm or the groin. A small sheath used to guide the catheter is threaded up to the heart, through a blood vessel, and positioned in front of the LAA. At this point, the Watchman is deployed and fits snugly over the opening to the LAA.
When the body detects a foreign object, it often tries to absorb or isolate it by developing scar tissue – and this is precisely the result we are looking for. Over the next several weeks, the body will develop scar tissue around the Watchman device, creating a strong and often permanent seal that keeps blood clots from the LAA filtered out of the cardiovascular system.
Watchman Procedure Information
Watchman device placement is typically very successful and safe, especially in the hands of an experienced electrophysiologist. The entire procedure takes less than an hour, not including prep and recovery time. Patients are usually released on the same day or kept at the hospital for one night for observation.
The risks of a Watchman placement are quite low. Most of the risk revolves around the insertion and guidance of the catheter up to the heart. Occasionally, patients may have some pain, blood loss, or infection at the incision site. Or rarely, there can be damage to the blood vessel walls used to guide the catheter up to the heart. Extremely rarely, patients may experience a cardiovascular event during the procedure. There is also the slight possibility that the Watchman device does not correctly seal the LAA.
However, the experience and technique of the electrophysiologist help mitigate these risks, and most often, the procedure is exceptionally successful.
If you are at risk of stroke due to Afib, we encourage you to make an appointment with your electrophysiologist to learn more about your options and the best ways forward. From lifestyle change to curative procedures, they have a wide range of options to handle any arrhythmia – straightforward or complex.
There was a stunning statistic from February 2021 about the Covid pandemic and how it has affected people’s weight. It was estimated that upwards of 40% of US adults had gained unwanted weight – an average of 42 pounds! But why? Our weight is directly correlated to several life events and their emotional effects, like:
- Stress. During the pandemic many of us were decidedly more stressed out. Stress can release additional cortisol into the blood which, in turn, can make us eat more. The result is often weight gain.
- Diet. Many of us liberalized our diets and drinking habits during the pandemic. While the memes of increased drinking during the pandemic made people laugh across the Internet, it represents a very serious concern both to mental and physical health.
- Exercise. There was a definite loss of motivation to exercise during pandemic time. Not only did many of us not even want to (or could) leave our homes, but there were fewer reasons to “look good” – no weddings or get-togethers, no in-person work, and Zoom calls from the shoulders up.
In the surgical world, there are few procedures that require as much preparation as Catheter Ablation. For example, hernia, gallbladder and even GERD patients may only need a consultation and a test or two before having the procedure. On the other hand, Catheter Ablation patients will undergo a full suite of cardiopulmonary and psychological testing; some will require a medical weight loss program and potentially more.
The process from deciding to have Catheter Ablation to the surgery date itself may require anywhere from 3-to-6 months depending on the patient’s general health and how they plan to pay. To start, many patients wonder if they are even candidates for Catheter Ablation. There are certainly standardized criteria that both the surgical practice and the FDA have outlined as necessary to have Catheter Ablation, such as a BMI of 35 or more with one or more obesity related comorbidities or a BMI of 40 or more regardless of comorbidities.
Your first consultation represents a very important start to the weight loss surgery process. You will have been introduced to one or more practices by attending a weight loss seminar. And while attending a bariatric seminar offers a degree of insight into the options, benefits, and risks of each bariatric procedure, it is not it does not mean that you necessarily qualify for Catheter Ablation. In fact, several tests to evaluate your suitability for surgery will be performed in the lead up to the procedure itself. The first step in that process, is to sit down with a bariatric surgeon for a consultation.
Many prospective Catheter Ablation patients believe that surgical intervention for obesity is a drastic measure. They’re concerns are understandable because surgery is, after all, invasive. Consequently, there are risks associated with any surgery including a weight loss procedure. It is important to remember, however, that while surgery is a last resort, it is also currently the most effective long-term method to combat obesity.
It’s also important to remember that other weight loss options may not be as safe or as effective as Catheter Ablation. For example, some may take dieting and/or exercise to the extreme causing significant stress on the body that can ultimately compromise their general health – physical and psychological. Further, diet and exercise regimens are not usually successful over the long-term and patients often regain some or all their weight, sometimes adding even more. Diet supplements have also flooded the market. These pills can be ineffective or even dangerous and there is very little oversight on the part of the federal government. Some diet pills contain extremely high levels of caffeine or other chemicals that can cause or worsen medical conditions.
Even before the pandemic, one of the questions we were most often asked is “How will my life change after my surgery and what does that mean for dining out?” The short answer is that the changes you need to make when eating at a restaurant are very similar to the changes you’ll have to make when eating at home. In the end, the diet after weight loss surgery should be one of moderation and balance.
It can be very difficult to control your appetite when at a restaurant. This is especially true when nights out have been as rare as four-leaf clovers during the pandemic. There are many temptations working against you. First and foremost, in a social atmosphere it is very hard to say “no” when everybody else is enjoying their meal. Secondly, restaurant portions tend to be quite large, often providing much more volume than you need. Thirdly, eating out often means not knowing how your food is prepared, including added fats, sugars and overall calories that are commonly hidden in the typical restaurant meal.
There is no lack of advice on all the ways that you can lose weight by modifying the way you work. Unfortunately, many of these tips and tricks, such as sitting on an exercise ball instead of an office chair or standing while working do not address the most dangerous part of our daily work and home habits – the sedentary lifestyle. While many of these tips can add to a healthy new lifestyle, some can harm us. So, before you subscribe to the latest fad in workplace weight loss, consider a few ideas:
Eating properly day-in and day-out is hard. Even harder is finding the time to cook a delicious, healthful, homemade meal while managing your busy schedule. To help you get through the week and still enjoy what you eat, you may want to consider prepping food for the entire week the weekend before. Of course, this is easier said than done; but once you realize how much time you save during the week, you’ll wonder why you didn’t do this sooner. Before we get started, it’s important to remember that the key to making this work is solid planning and preparing a variety of foods. Eating the same old thing every day, even if it is something you like, gets old very fast. Prepping a few staples that can either be eaten as a meal, a side dish, or a snack will not only save you time, but may become your new normal once you see how easy and efficient it can be.