RCRH heart device to decrease chance of stroke

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Every year, nearly 800,000 individuals have a stroke in the United States. Rapid City Regional Hospital has been implanting a stroke-decreasing device since February 2017 and have performed 14 procedures.

The device, known as the WATCHMAN, is targeted at people who suffer from atrial fibrillation (AFIB). It’s a heart condition that causes the heart to beat irregularly. Because of this, blood may not fully be pumped out of the heart.

Dr. Joe Tuma, medical director of the cardiology program at RCRH, says an irregular heart rhythm affects the top two chambers of the heart, where the left atrium essentially loses the ability to shrink and contract.

“Anywhere where blood pools - clots have a tendency to form,” Tuma says. “And so really, our biggest fear with AFIB is stroke.”

Strokes are preventable through blood thinners, such as Warfarin. But not everyone can take anticoagulants due to associated bleeding risks.

Tuma says more than 90 percent of stroke causing clots that form in the heart, occur in the left atrial appendage (LAA).

“About 95 percent of the time, the left atrial appendage, which is just a little outpouching off of the left atrium - that’s where the clots form,” Tuma says. “Essentially, that’s the target for the WATCHMAN device.”

The device is umbrella shaped and relatively malleable. The permanent closure implant is inserted into the plugging the area to prevent a stroke.

The procedure to implant the device takes about an hour. Dr. Jose Teixeira, a cardiologist at RCRH, says the procedure is essentially transvenous.

“We don’t have to cut anything,” Teixeira says. “We find the vein that goes from the leg to the heart and cross the other side of the heart, called the left atrium, and deploy the device there.”

Tuma says that although implanting the WATCHMAN device isn’t the first line of therapy, it may be easier on your wallet as opposed to long-term medication.

“The cost of the implant is about $34,000 over 10 years,” Tuma says. “And most of that is the upfront cost of the device and the procedure. The cost of Warfarin therapy is around $40,000 over 10 years, and then the cost of the novel - the newer agents - is around $65,000 a year.”

In South Dakota, four cardiologists can perform the WATCHMAN implantation, and two are in Rapid City.

In a clinical trial, 9 out of 10 people could stop taking Warfarin 45 days after the WATCHMAN procedure.

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