ELECTROPHYSIOLOGY DIVISION “ FIRSTS ” IN FY16
• Commercial use of Watchman ®* device after years of clinical trials and patient follow-up at Baylor Hamilton Heart and Vascular Hospital
• Commercial use of Micra ®** – the world ’ s smallest lead-less pacemaker
* Registered to Boston Scientific . Image used with permission . ** Registered to Medtronic . Image used with permission .
More than
984
Pacemakers / ICDs implanted in FY16
LEFT ATRIAL APPENDAGE OCCLUSION ( LAAO )
Cardiologists on the medical staff at Baylor Jack and Jane Hamilton Heart and Vascular Hospital have been instrumental in driving change and innovation for treatment strategies to prevent blood clot formation in patients suffering from atrial fibrillation . LAAO occlusion generally eliminates the risk of stroke without the need for blood thinners . Electrophysiologists on the medical staff have been successful with bringing the Watchman ® device through clinical trials and post FDA approval . With the fiscal year 2016 approval by the FDA after years of research and clinical trials proving its effectiveness , this device is a viable options for patients .
A-Fib can decrease the heart ’ s pumping efficiency by as much as 30 percent . Poor pumping increases the risk of clots forming in the heart chambers , particularly the left atrial appendage ( LAA ). The LAA is pouch-shaped and about the size of your thumb . It is located on the top of the heart . The Watchman ® device is designed to prevent blood clots that frequently form in the LAA from traveling in the blood stream to the brain , lungs and other parts of the body . Clots that travel to the brain cause strokes , one of the leading causes of death and disability .
“ The Watchman ® device is implanted in the left atrial appendage using minimally invasive techniques ,” says James Choi , MD , cardiologist on the medical staff at Baylor Hamilton Heart and Vascular Hospital and one of the investigators involved in the Watchman ® early studies . “ The parachute-shaped device is the size of a quarter and consists of a nitinol cage with a polytetrafluoroethylene membrane and includes a row of fixation barbs . The interventional cardiologist uses fluroscopic imaging to guide a sheath into the LAA . The sheath serves as a duct for the delivery of a catheter that is pre-loaded with the Watchman ® device . The catheter is advanced to the tip of the access sheath and is deployed by a gentle retraction of the sheath .”
With this device , patients are generally released from the hospital after 24 hours . Medical follow-up continues over the course of time as patients decrease their blood thinner medication under the supervision of a cardiologist .
Watchman ® helps prevent blood clot formation in A-Fib patients . * Image courtesy of Boston Scientific
Watchman ® device is suitable for patients with nonvalvular atrial fibrillation who :
• Are at increased risk for stroke and systemic embolism based on CHADS2 or CH2DS2-VASc scores and are recommended for anticoagulation therapy
• Have an appropriate rationale to seek a non-pharmacologic alternative to warfarin , taking into account the safety and effectiveness of the device compared to warfarin .
“ It is also important for patients to understand that , like blood thinning medications , the Watchman ® device does not cure atrial fibrillation ,” says Dr . Choi . “ It is also important to know that a stroke can occur as a result of factors not related to a clot traveling to the brain from the left atrial appendage . Other causes of stroke can include high blood pressure and narrowing of the blood vessels to the brain .”
DEVICE LEAD EXTRACTIONS
Electrophysiologists on the medical staff at Baylor Hamilton Heart and Vascular Hospital are often referred patients with complex conditions needing removal of leads because of electrical malfunctions , blocked blood vessels , or infection . In most cases , the leads can be removed using a catheterbased approach .
OUTCOMES 2016
35