Dr. Devi G. Nair, electrophysiologist at St. Bernards Medical Center in Jonesboro, is the first physician in Arkansas to offer patients with non-valvular atrial fibrillation (AF) an alternative to long-term warfarin (blood-thinning) medication with the newly approved Watchman Left Atrial Appendage Closure (LAAC) Implant.
When patients experience atrial fibrillation, the upper chambers of the heart (the atria) do not pump properly. The upper chamber of the left side of the heart contains a small “pouch” – the left atrial appendage – which is a common site for blood pooling during AF. It is a prime site for blood clotting, and when clots form it puts the patient at a higher risk of having a stroke because of the potential for the clot to break free and travel to the brain.
Typically, patients with AF are treated with blood thinners (warfarin) to reduce the risk of stroke. However, these medications can lead to bleeding complications and the need for frequent lab testing.
St. Bernards was the first facility in Arkansas to deploy the Watchman device and now has the largest Watchman program in the state, says a representative from Boston Scientific, the firm which manufactures the Watchman device as a non-drug alternative to stroke prevention.
Watchman is designed to close off the left atrial appendage to prevent harmful blood clots from that area from entering the bloodstream and potentially causing a stroke. By closing off the LAA, the risk of stroke is reduced and, over time, patients may be able to stop taking warfarin.
The FDA approved use of the Watchman device in the United States in 2015, and the first deployments in this country were in large centers that participated in clinical trials to affirm the safety of the Watchman.
The device itself is a quarter-sized mesh “cap” that is inserted as a closed disc through a catheter into the femoral vein (in the groin or leg) and advanced into the LAA. Once it is positioned properly, it is expanded in the LAA to form a tight seal.
The procedure is performed under general anesthesia and typically takes 1-2 hours, followed by an overnight hospital stay.
The St. Bernards implant team is led by Dr. Devi G. Nair, elecrophysiologist with St. Bernards Heart & Vascular who serves as director of the electrophysiology program at St. Bernards. She is quick to credit the entire team for their roles in Watchman procedures.
“Having a highly trained electrophysiology team coupled with noninvasive cardiology and anesthesia has made each of our implants successful,” Nair stresses. “The work of this team enables us to provide the highest quality of atrial fib care for our patients.”
AF is the most common cardiac arrhythmia and affects more than 5 million Americans. Twenty percent of all strokes occur in patients with AF, and AF-related strokes are more frequently fatal and disabling.
Watchman has been used in Europe for more than a decade and has been implanted in more than 10,000 patients in more than 70 countries worldwide.
Boston Scientific is a worldwide developer, manufacturer and marketer of medical devices – including Watchman – that are used in a broad range of interventional medical specialties.
Nair, who sees patients at St. Bernards Heart & Vascular, is one of two electrophysiologists on the medical staff at St. Bernards. She has performed a number of national, statewide and regional “firsts” since coming to Jonesboro in 2011.
The first patient to receive a Watchman Implant at St. Bernards was Jonesboro resident Charles Frierson III, whose surgery was performed earlier this summer. Since that time Nair and her team have performed nine other successful Watchman surgeries.