Someone to Watch Over Me
Marcia Hougen, a recently retired educator and musician, loves being a grandmother – especially when it comes to telling bedtime stories and singing lullabies. Perhaps someday, she’ll share the extraordinary tale with her grandchildren about the tiny WATCHMAN™ that lives in her heart, guarding her against the risk of a disabling or life-threatening stroke. She won’t have to fabricate the details. It’s a true story.
The WATCHMAN entered Marcia’s world (and her heart) in October 2015, when she underwent a new procedure at Abington’s Heart and Vascular Institute – Jefferson Health. There, cardiac specialists implanted the WATCHMAN Left Atrial Appendage Closure (LAAC) Device to help reduce the risk of stroke from Marcia’s heart rhythm disorder known as atrial fibrillation (A-fib). In 2015, Abington Hospital became one of the first centers in Pennsylvania to use the WATCHMAN – the only device of its kind approved by the FDA – for treatment of select patients with A-fib as an alternative to drug therapy to reduce their risk of A-fib-related stroke. Specialty trained in the WATCHMAN procedure, Richard Borge Jr., MD, director, Atrial Fibrillation Program and medical director, Heart Rhythm Center; and Bruce Klugherz, MD, director, Abington Hospital’s catheterization lab, combined their expertise in electrophysiology and interventional cardiology to implant Marcia’s device.
“Affecting nearly 6 million Americans, A-fib is the most common type of irregular heartbeat,” said Kelly Applebaum, CRNP, valve coordinator, Cardiothoracic Surgery, Abington. This disturbance in the heart’s electrical system can result in the formation of blood clots in a section of the heart known as the left atrial appendage. If a clot forms and breaks loose, it may travel to the brain and cause a stroke. The device permanently seals off the LAA, eliminating the possibility of clots forming there.
Until now, drug therapy with prescription blood thinners – most commonly, warfarin – was the only treatment available to reduce the risk of stroke in people with A-fib that is not related to heart valve disease. Unfortunately, one of the complications of blood thinners is a greater risk for bleeding in the brain or elsewhere in the body, especially after trauma such as a fall.
Falling Into a Life-Changing Treatment Option
Marcia, 71, was diagnosed with atrial fibrillation in 2006, upon returning to the U.S. after a trip to El Salvador with a church group. “During our trip, I noticed I became easily fatigued after climbing stairs and had difficulty keeping up with others while walking,” she recalled. When she returned home, a visit to the doctor led to testing that showed Marcia’s heart was in atrial fibrillation. “Over the course of that year, I was in and out of the hospital, trying different medications and heart procedures and finally, my heart went back into normal rhythm,” she said. Thereafter, Marcia’s heart rhythm remained normal, aside from an episode of A-fib in 2013.
“When I went into A-fib again in the summer of 2015, it came on the heels of multiple hospital stays for two serious falls,” said Marcia. “After the first fall, the entire left side of my body was black and blue from internal bleeding.” The second fall resulted in three fractures in Marcia’s foot, leaving her wheelchair-bound and facing weeks of inpatient rehabilitation therapy, followed by additional months of outpatient therapy. In the midst of the rehabilitation process, Marcia was hospitalized again for A-fib.
“At that point, Dr. Borge recommended the WATCHMAN implant,” said Marcia. “We had tried everything else and we were concerned about continuing with blood thinners when I am at higher risk for falls, and therefore, major bleeding.” After the procedure, Marcia spent one night in the hospital and was discharged home. In time, doctors are hopeful they will be able to discontinue Marcia’s blood-thinning medication altogether.
In the meantime, Marcia remains focused on three straightforward goals. “I’m going to stay out of the hospital, keep singing and finally start enjoying my retirement,” she said.
For more information about all cardiac services offered by Abington – Jefferson Health’s Heart and Vascular Institute physicians and surgeons, visit Jefferson.edu/AbingtonHeart or call 215-481-MEDI.