Presbyterian Heart Hospital offers device for reducing stroke risk

[steve williams]

By Steve Sinovic / Journal Staff Writer

ALBUQUERQUE, N.M. — A new device and procedure now offered at the Heart Center at Presbyterian Medical Center may be a stroke risk reduction alternative to taking blood thinners for patients who have the most common form of atrial fibrillation.

A team led by Dr. Sharif Halim, an interventional cardiologist, successfully implanted the Watchman device in three patients in July at the Heart Center.

“We are proud to be the first and only hospital in New Mexico to implant the Watchman,” said Dr. Robert Federici, medical director of The Heart Center at Presbyterian. “This is just one example of the many ways we’re investing in technology to provide our patients with alternative options and improved quality of life.”

He said many patients with atrial fibrillation, an irregular heart rhythm, often take blood thinners to reduce their risk of stroke. But blood thinners are not always tolerated long term due to the increased bleeding risks with other medical conditions.

The implanted device resembles a small jellyfish and allows patients to go off blood thinners after a few months.

Presbyterian is one of approximately 100 hospital systems across the country to offer the technology.

According to manufacturer Boston Scientific, atrial fibrillation is the most common cardiac arrhythmia, currently affecting more than 5 million Americans. Twenty percent of all strokes occur in patients with atrial fibrillation, and atrial fibrillation-related strokes are more frequently fatal and disabling, according to Federici.

He estimates that Presbyterian will implant 60 to 80 devices in patients this year, adding that studies have shown the device to be more cost-effective than blood thinners. And most patients like the idea of a device rather than taking 5-10 pills a day, depending on the severity of the atrial fibrillation.

In a procedure that usually takes about an hour, the Watchman is implanted on the left atrial appendage of the heart, which is the source of 90-95 percent of strokes, said Dr. Halim. It helps prevent blood clots from circulating and traveling into the brain, causing a stroke.

While Presbyterian declined to divulge the costs associated with implanting the device, the Watchman achieved cost effectiveness relative to the blood-thinner warfarin at seven years, according to a Dec. 22, 2015 article in the Journal of American College of Cardiology.

The procedure has been approved for Medicare and Medicaid recipients.

 

[RBFC]

That's where I work. Cool stuff.

Lee

 

[Asamel]

When's the recall?

 

[Folsom]

Here, just put this alien Jellyfish onto your heart??? Wtf is it???

I'm still at a zero understanding of why any doctor prescribes pharmaceutical blood thinners when Nattokinase is so widely avaliable and safe.

 

[RBFC]

The highly litigious nature of Western society pretty much guarantees that attempts to launch lawsuits regarding this device will happen. Whether homeopathic or manufactured pharmaceutical, substances that reduce the blood's ability to clot carry many severe risks themselves (with many commercials instructing viewers to "call 800-xxx-xxxx if you or a loved one have suffered "X" or "Y" while taking it).

Atrial fibrillation causes thrombotic stroke by leaving areas of stasis in the left atrium (primarily the left atrial appendage) and allowing clots to form there, which are subsequently pumped directly to the brain upon leaving the heart. The left atrial appendage is a mostly unnecessary anatomical feature. During our open-heart surgeries, when a history of atrial fibrillation is documented, we often "ligate" (sew or clip off) the atrial appendage to eliminate this area prone to clot formation.

This device allows a relatively safe deployment of this "net" via a catheter without the need for highly invasive surgery. As with all "closed" & " minimally-invasive" procedures, the desire for these procedures is driven by the patients' fears of the traditional surgical approaches. Also, these catheter-driven modalities can be performed by cardiologists (not surgeons) and will increase their revenue. In some patients for whom traditional surgery is not indicated, this device may provide the protection they need.

Lee

 

[steve williams]

Thanks for the feed back Lee

 

[rockitman]

Thanks for the feed back Lee

So how do clots form ? Is it from blood pooling and not exciting one of the heart chambers in a pump cycle ?

 

[Folsom]

It's a pocket, sorta, where it's easy for fibrin or whatever to settle.

Here's an idea of what a device is like for it.

I suspect that it might be a place for unnecessary fibrin (or oddities) to land and break apart. That is, in a healthy person. For someone prone to blood clotting it may accumulate and pool fibrin platelets that don't break apart and form larger and if they move well... That's why we're looking at this thread.

 

[RBFC]

So how do clots form ? Is it from blood pooling and not exciting one of the heart chambers in a pump cycle ?

Imagine those eddy pools that border a fast-flowing river. The water sits fairly still and has little mixing. Blood, when allowed to sit still for a length of time, will form clots. Then, an incident that "shakes things up", such as a cough, etc will allow the clot to enter the fast-moving stream of blood (your normal circulation). Unfortunately, the first place that these clots can be trapped is in the cerebral circulation.

The same stasis effect occurs in the deep vein thrombosis events seen in long-distance plane travelers. Blood sits stagnant in the leg veins and forms clots, which then dislodge upon movement and travel to the lungs.

Lee

 

[Asamel]

I'm still at a zero understanding of why any doctor prescribes pharmaceutical blood thinners when Nattokinase is so widely avaliable and safe.

We're talking about real medical problems that require real medications. Nattokinase has no place in a discussion of blood thinners for thrombosis, afib, valve disease/replacement. There is essentially no research on it because the companies that sell it don't do research.

 

[RBFC]

Herbal/homeopathic drugs often vary greatly in purity and efficacy. Without reasonable assays of their quality, consumers typically get less than they pay for AND treatment with them can range from ineffective to dangerous. Pharmaceutical drugs often have roots in natural substances; they are merely refined and tested versions of their natural precursors.

Lee

 

[Folsom]

Please, there's obvious reasons why a pharmaceutical company would be uninterested. Nattokinase has been found to be quiet powerful, and safe. I suggest you do a search for peer reviewed articles before claiming there's nothing there. Besides that we all know that it's common for these so called wonder drugs to have impossible to replicate studies; as well as deadly side effects. Why have opposition to other treatment if it's plausible? Because the companies willing to make the product can't afford studies?

You make it sound like pharmaceutical companies are benevelonet...

 

[Folsom]

Herbal/homeopathic drugs often vary greatly in purity and efficacy. Without reasonable assays of their quality, consumers typically get less than they pay for AND treatment with them can range from ineffective to dangerous. Pharmaceutical drugs often have roots in natural substances; they are merely refined and tested versions of their natural precursors.

Lee

There's no reason why standardized natural treatments can't be a norm. There's just as many placebo quality pharmaceuticals as low grade natural products. As a side note at least taking extra natural treatments won't make you bleed out...

And I highly suggest you look up what homeopathic means because it's irrelevant to the discussion here and unrelated to even herbal items. It's not that I want to be rude, but wow, that's ignorant.

 

[FrantzM]

Please, there's obvious reasons why a pharmaceutical company would be uninterested. Nattokinase has been found to be quiet powerful, and safe. I suggest you do a search for peer reviewed articles before claiming there's nothing there. Besides that we all know that it's common for these so called wonder drugs to have impossible to replicate studies; as well as deadly side effects. Why have opposition to other treatment if it's plausible? Because the companies willing to make the product can't afford studies?

You make it sound like pharmaceutical companies are benevelonet...

Utterly, completely and <placeholder for another adverb> out of my element and of any of my very limited areas of expertise. Still ...

It seems to me that there is a rather substantial peer-reviewed body of work on Nattokinase .. as for the benevolent, generous and philanthropic nature of the Pharmaceutical Industry, it would be difficult to be more oxymoronic than that.

 

[RBFC]

Homeopathic preparations are made from both plant and animal sources, thus giving them relevance to be (merely) mentioned in this discussion. In the same way that herbal treatments are often difficult to dose (due to varying potency of ingredients), I could not find sufficient evidence to support that there has been a standardized dosage table developed for nattokinase. While its anticoagulant properties are real, there are insufficient studies that would allow one to meter an effective but safe dosage for individuals across a patient population. Those who take a couple capsules of this preparation to avoid deep vein thrombosis during plane flights have no idea if they have achieved a therapeutic blood level of the substance, and there is no solid evidence (nor sufficient studies) to show otherwise.

I have no special love for pharmaceutical companies, but find that the alternatives often carry equal or worse problems.

Finally, while it is completely acceptable for you to have an agenda in this discussion, it is unnecessary for you to use unfounded insults as part of your post. While those insults are against our Terms of Service, I am participating in this discussion as a member rather than a moderator. Your attempt to strengthen your argument by insulting the "debate opponent" has not made any impact on my understanding of blood coagulation. I use various anticoagulation therapies daily in my job: operating the heart/lung machine for open heart surgery, and have 36 years of experience in the field. If and when a dosage/efficacy standard is developed for nattokinase, I will consider it a viable entity.

Lee

 

[Folsom]

Please don't think I'm not great full that we have certain drugs. I'm extremely thankful for a lot of emergency medical capabilities too. But to be frank there's been more cures found within other channels, for pathology (not saying cancer, though), than the pharmaceutical companies have provided. Hence that it all plays rolls.