"Watchman" may lower stroke risk

Parachute-like device prevents blood clots in patients with irregular heartbeats

A SMALL parachute-like device may be the answer to preventing strokes in people with irregular heartbeats especially those who cannot take drugs to cut down the risk.

The National Heart Centre, which has been implanting the devices since October, is believed to be the first in Asia to do so.

Known as the "Watchman", the device is implanted in the heart from a catheter inserted through the groin, much like how a balloon or stent is brought to the heart. When deployed, it opens up like a parachute and blocks off the left atrial appendage, a thumb size outcrop of the heart where 90 per cent of blood clots in the heart form.

This technique can potentially benefit up to 100 patients a year who have irregular heartbeats but cannot take warfarin, a drug to prevent blood clots, said Associate Professor Koh Tian Hai, the centre's medical director.

Up to 1 per cent of the population have irregular heartbeats, and these people are five times more likely to suffer from stroke because blood tends to stagnate and clot in the heart, especially in the left atrial appendage.

These blood clots may then travel to the brain and cause a stroke.

Patients are usually given warfarin to thin their blood but in some people, it causes internal bleeding. These include patients with ulcers and fragile blood vessels as well as those prone to falls, said Dr Teo Wee Siong, a senior consultant at the centre.

Such patients are given milder drugs that do not work as well in preventing strokes he added.

Studies done in the United States and Europe showed that patients on the Watchman have a lower risk of stroke than those using warfarin, said Prof Koh.

But as it has been available only in the last few years, it is still too early to determine its long-term effects, he added.

For now, the centre will use the Watchman only on those who are unsuitable for warfarin.

There is a 1 per cent risk of complication with the procedure ,and while the doctors have not come across cases of the device getting dislodged, they do not discount the chances of it ever happening.

Retiree Cheong Ching Chuan, 70, was the first of three people here to get the implant.

After taking warfarin for many years because of his irregular heartbeat, he had to be taken off the drug after he hurt his head in August and had bleeding in the brain.

"I had to watch what I ate last time because it may affect the drug. Now, 1 no longer have to take warfarin and can still prevent stroke," he said.

will teach her how to take a bus probably in a year's time. She should be ready by then," said Dr Chung.