Device under study gives hope of preventing thousands of strokes

The device would help with the most common type of irregular heartbeat.
WASHINGTON (AP) -- At least 120,000 Americans a year suffer strokes because of a common irregular heartbeat -- one that's on the rise, hard to treat and can shoot deadly blood clots straight to the brain.
Now doctors are experimenting with a new way to prevent those brain attacks: a tiny device that seals off a little section of the jiggling heart where the clots form.
If it works -- and a major study is under way -- the Watchman device might provide long-needed protection for thousands of people with atrial fibrillation whose main hope now is a problematic blood-thinning drug that too many can't tolerate.
"I don't think I'm biased, but it could potentially revolutionize a-fib, which is a ton of people," said Dr. Steven Almany, vice chief of cardiology at William Beaumont Hospital in Royal Oak, Mich. He has implanted the Watchman into more than a dozen patients so far.
Type of irregular heartbeat
About 2.8 million Americans have atrial fibrillation, the most common type of irregular heartbeat. It is most common among the elderly, and cases are increasing as the population grays.
A-fib occurs when the heart's top chambers, called the atria, get out of sync with the bottom chambers' pumping. The atria speed up, sometimes so fast that they quiver like a bag of worms. Blood pools inside a pocket of the heart, allowing clots to form.
About 20 percent of the nation's strokes are attributed to the condition, and they tend to be particularly severe. About a third of the victims die, and another third are significantly disabled, Almany said.
The blood thinner warfarin, also called Coumadin, lowers the stroke risk dramatically. But it is very difficult to use -- it can't be taken together with dozens of other medicines, and requires dietary restrictions and regular blood testing. In addition, side effects include serious, even life-threatening, bleeding.
How device works
In atrial fibrillation, 90 percent of stroke-causing blood clots collect inside a jalapeno pepper-shaped flap of tissue that hangs off the edge of the left atrium. Some call it the heart's belly button, a leftover from fetal development that the body no longer needs.
The Watchman physically seals off that flap, depriving clots of their staging area. The question is whether that really will stop strokes. To find out, doctors are recruiting hundreds of patients around the country to get either the experimental device or the usual Coumadin.
If the Watchman ultimately works, Almany predicted, the procedure could cost 12,000 or so, less than treating a stroke or a bad Coumadin side effect.
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