Services

Arrhythmia Management and Electrophysiology

Arrhythmia Management and Electrophysiology

Arrhythmias are electrical problems within the heart that affect millions of patients each year. Either in following patients with established arrhythmias or evaluating patients who have symptoms concerning for an arrhythmia such as palpitations, the arrhythmia monitoring program at CAFC provides comprehensive care to those in our community. Early detection and management are the keys to a successful outcome in patients who suffer from arrhythmia. The electrophysiology team at CAFC is comprised of board-certified cardiologists who focus on the treatment of these conditions. They provide a range of treatments from consultative assessments to medical therapy, pacemakers, defibrillators, and ablation. The CAFC electrophysiologists are supported by physician assistants in the office and hospital to expedite care and provide support for patients and their families.

Atrial Fibrillation Management

Atrial Fibrillation Management

All CAFC providers are expert in the management of atrial fibrillation and work closely with the electrophysiology team to tailor a regimen specific to each patient. Most patients with AF will take blood thinners (anticoagulants) to prevent the blood clots that cause strokes. Outpatient AF management is conveniently offered at all CAFC offices. AF ablation is performed by the CAFC electrophysiology team at St. Vincent’s Medical Center and Stamford Hospital.

Cardiac Genetics

Cardiac Genetics

Like most conditions, there is a genetic component to many cardiovascular diseases. Some conditions have a very strong genetic pattern like cholesterol disorders or structural conditions of the heart muscle. In other diseases such as hypertension or coronary artery disease, your genetic background might be a part of the cause of your condition. Understanding the genetics of heart disease can be complicated but important in creating an optimal treatment plan. The team at CAFC works with a cardiac geneticist to better understand the genetic component of heart disease so we can help ensure you receive the most comprehensive care possible.

Cardio-Oncology

Cardio-Oncology

With rapid advances in both cardiac and cancer care, people are living longer after their diagnoses, increasing the likelihood that a person with cancer might suffer from a cardiac event. Specific populations, particularly older women, are at much higher risk for such a complication. In addition, certain oncological treatments - which are life-saving therapies for cancer - can trigger or worsen a cardiovascular condition. Using advanced imaging techniques, our cardio-oncology team will work with your oncologist to monitor your cardiovascular condition during your cancer treatments to help ensure a successful outcome.

Congestive Heart Failure Management

Congestive Heart Failure Management

We provide the most up-to-date treatments to manage CHF and avoid complications. Using a combination of office-based drug therapy, a heart failure clinic, arrhythmia device management, invasive pressure monitoring, and coordination with heart transplantation experts, CAFC can help you manage this chronic condition and improve both your quality and quantity of life.

Coronary Artery Disease Treatment

Coronary Artery Disease Treatment

Treatment of CAD focuses on the primary cause but often involves a combination of medical therapy, lifestyle changes, exercise, and interventional restoration of flow when needed. Your cardiologist at CAFC will create a unique treatment plan in line with the most updated guidelines and recommendations to prevent progression of CAD and the complications it can cause.

High Cholesterol Management

High Cholesterol Management

As part of a comprehensive treatment plan, our team at CAFC can help you modify this risk factor and help avoid new or recurrent cardiovascular events. CAFC has been on the forefront of research expanding our knowledge of high cholesterol and its treatments. You can also view a video here.

Hypertension Management

Hypertension Management

If left untreated, high blood pressure can result in serious complications including strokes, kidney failure, heart failure, or heart attack. When treated correctly, those complications can be avoided. Our team at CAFC are experts in the diagnosis and management of your high blood pressure and work in concert with your primary care provider to help you achieve your ideal blood pressure goals.

Pacemaker Interrogation

Pacemaker Interrogation

The electrophysiology team at CAFC are experts in diagnosing and managing conditions that warrant the insertion of pacemakers and are highly skilled in the implantation and management of whatever device is required. These devices can, in part, be monitored from your home as part of the CAFC remote monitoring program. Pacemakers can be inserted by the CAFC electrophysiology team in all our affiliated hospitals and device management is conveniently performed in most of our outpatient locations.

Preventive Cardiology

Preventive Cardiology

Avoiding a cardiovascular problem is the ultimate goal for patients, families, and providers. Preventive cardiology assesses a patient’s risks for future cardiac events and creates a plan to lower those risks. Using an interdisciplinary approach including clinical evaluations, lipid assessments, and coronary calcium scoring, a treatment plan can be created to prevent a cardiac condition. Watch a video here.

Valvular Heart Disease Treatment

Valvular Heart Disease Treatment

At times, medications or valvular interventions with surgery or catheters may be required. Catheter-based treatment of valvular heart disease is one of the most dynamic and exciting areas in cardiology. The physicians at CAFC are all experienced in the management of complex valvular heart disease and will create a diagnostic and treatment plan to improve your quality of life and ensure your best outcomes.

Vascular Interventional Services

Vascular Interventional Services

Unfortunately, Peripheral Arterial Disease is often asymptomatic or it can mimic the symptoms of several other conditions. As a result, it can be underdiagnosed which can lead to delayed or missed diagnoses. Thankfully, with proper clinical evaluations and testing, PAD does not need to lead to complications. The team at CAFC is adept at the evaluation and treatment of PAD. Often, an initial evaluation includes a history of symptoms and a physical examination. If needed, several tests can be performed to determine the presence and extent of PAD. Usually, these include blood pressure tests of the arms and legs, ultrasounds of the arteries involved, and CT scans or MRIs. Frequently, mild or moderate PAD can be treated with a combination of medications, lifestyle changes, and exercise. If necessary, more severe cases may require more intensive therapies. All clinicians at CAFC are expert in the assessment and treatment of PAD. The interventional team can perform peripheral angiograms and other such procedures at all of our affiliated hospitals.

Vascular Medicine

Vascular Medicine

Cardiovascular disease does not just affect the arteries of the heart. Vascular disease can affect all arteries in the body and can lead to problems including stroke, kidney failure, and amputation. Using a combination of clinical assessments, diagnostic imaging such as ultrasound and CT, and interventional (angioplasty) therapies, the team at CAFC can help you manage all aspects of your vascular condition, improve symptoms, and avoid complications.

Women’s Heart Disease

Women’s Heart Disease

Historically, heart disease was felt to be a condition that predominantly affected men. Women who suffered from cardiac conditions were either misdiagnosed or diagnosed far too late, in part because women's symptoms of heart disease are different than those that men feel. We now understand that heart disease affects both women and men and, in some age groups, can affect women at a greater rate than their male counterparts. In fact, while one in seventeen women will tragically die from breast cancer, one in three will die from cardiovascular causes over the course of her life. Understanding the differences in the presentation of heart disease in women, how heart disease can affect them after it occurs, and the differences in heart testing between women and men is critical for a successful outcome. The specialists in women's heart disease at CAFC will help you throughout your cardiac process. We have been proud supporters and sponsors of the Women at Heart program since its inception at St. Vincent’s Medical Center in 2012. This program has raised hundreds of thousands of dollars to help underserved women receive the cardiac care they need.

DIAGNOSTIC TESTING OFFERED

Calcium Scoring

Calcium Scoring

A coronary CT calcium scan is a computed tomography (CT) scan of the heart for the assessment of severity of coronary artery disease. Specifically, it looks for calcium deposits in the coronary arteries that can narrow arteries and increase the risk of heart attack. This severity can be presented as a coronary artery calcium (CAC) score, which is an independent marker of risk for cardiac events, cardiac mortality, and all-cause mortality. In addition, it provides additional prognostic information to other cardiovascular risk markers.

Echocardiography

Echocardiography

This is another term for an ultrasound of your heart. Like ultrasounds for other conditions, a cardiac ultrasound is a painless procedure that does not require preparation such as fasting. This ultrasound uses high frequency sound waves to create a real time, moving image of your heart and all its structures and functions. Echocardiography will provide your CAFC provider with information about the size, thickness, and strength of the heart as well as the status of its valves, the pressure within it, and the presence or absence of any abnormal components such as fluid collections or growths. Echocardiography can be used to help determine the cause or significance of a symptom, abnormalities found on other tests such as electrocardiography, for recovery of a weakened heart muscle, and other indications. In some patients, particularly those with valvular heart disease, echocardiography may be performed with some regularity to follow the progression of their condition. Most echocardiograms are performed with the probe placed on the chest.

Electrocardiography

Electrocardiography

An electrocardiogram (ECG/EKG) is a simple test that can give your provider a great deal of information about the size, structure, and function of your heart. It can also determine if you have had a prior heart attack or other cardiovascular issues. ECGs are not painful, require no preparation, are very quickly performed, and results are immediately available to your provider. They are often performed in patients with symptoms concerning for a heart condition or in the setting of an abnormal finding on a physical examination. In patients with a chronic cardiac condition, an ECG is part of your routine office evaluation to determine if there has been any change in your cardiac status. Electrocardiography is available at all CAFC offices.

Holter Monitor

Holter Monitor

Holter monitors are simple devices worn on the chest that digitally record the rhythm of the heart for 24 or 48 hours. Event monitors are longer term devices that are also worn externally and collect similar information. They can be used for up to a month. Our modern devices can be worn in the shower, and you do not need to alter your daily lives when using them. Regardless of duration, the recorded electrical system of your heart will be evaluated by the cardiology team at CAFC to help determine the proper treatment course for your condition.

Implantable Loop Recorder

Implantable Loop Recorder

At times, even longer-term monitoring is required than is possible with a wearable device, such as in cases where a patient had a stroke or experiences repetitive fainting. In these situations, the electrophysiology team at CAFC can insert a tiny monitor just under the surface of the skin on the left chest. The procedure is very safe, requires no preparation, and does not involve a great deal of pain. These monitors wirelessly transmit heart rhythm abnormalities directly to our offices where they are reviewed by the electrophysiology team. Arrhythmia monitoring is conveniently available in all CAFC offices.

Nuclear Cardiac Imaging

Nuclear Cardiac Imaging

Imaging the heart is a critical component to understand your symptoms, your cardiac status, and to determine what treatment plans are appropriate and necessary for you. One form of non-invasive cardiac imaging is nuclear cardiology. This advanced form of heart testing uses low doses of safe and very short-acting radioactive tracers to allow your team at CAFC to create an image of your heart. A specialized form of stress testing using nuclear imaging can track the blood flow into your heart either after exercise or after the administration of a medication that simulates exercise. This nuclear scan is considered the ‘gold standard’ in determining the status of the blood flow to your heart. Other applications of nuclear cardiology include very precise evaluations of your heart function (MUGA/ERNA scans or assessments of abnormalities of the muscle of your heart [amyloidosis]). This test offers very reproducible results and is often performed when following heart function during certain chemotherapy regimens. CAFC offers convenient outpatient nuclear cardiac imaging in our Stamford, Norwalk, Bridgeport, and Milford offices. All nuclear scans are interpreted by CAFC’S board-certified nuclear cardiologists.

Stress Testing/Stress Echocardiography

Stress Testing/Stress Echocardiography

Stress testing is one of the most performed tests in any cardiology office. The heart can supply itself with blood at rest even in the setting of severely narrowed heart arteries if that narrowing occurred gradually over time. However, enough blood cannot get to the muscle of the heart through a narrowed artery when the heart works harder, like during exercise. Stress testing can help your provider determine if your symptoms are related to a blocked artery and lack of blood flow to the heart muscle. In certain situations you will exercise on a treadmill and will be monitored with an electrocardiogram. Changes on the electrocardiogram, symptoms, or variations in your blood pressure with exercise could indicate a problem with the blood flow to your heart and may prompt additional testing or other treatments. At times, more information than can be obtained with traditional stress testing may be required. In that situation, stress echocardiography can be performed by obtaining limited ultrasound images of your heart before and after exercise. Those images are compared for any changes in heart muscle contractions to suggest a problem with the flow through the arteries of your heart. At times, stress testing can be performed for reasons not related to the blood flow to your heart. Your provider at CAFC may use stress testing to determine the impact of a valve on the function of your heart, your overall exercise capacity, or how your blood pressure responds to physical activity. All stress tests are supervised by the nursing and physician teams at CAFC and are interpreted by our board-certified cardiologists. Reports are sent to your primary care provider, any other provider you might request, and are available for review on My Chart Plus. Stress testing and stress echocardiography are available at all CAFC offices.

Transesophageal Echocardiogram (TEE)

Transesophageal Echocardiogram (TEE)

For those conditions requiring a more precise evaluation, a specialized ultrasound probe is inserted through the mouth into the esophagus (swallowing tube), and into the stomach since the heart is right in front of the esophagus in the chest. This procedure is very similar to a GI endoscopy and is typically performed by a CAFC cardiologist with sedation for patient comfort and at the hospital to ensure patient safety. A transesophageal echocardiogram does require an overnight fast. Transthoracic echocardiography is conveniently offered at all CAFC offices and transesophageal echocardiography can be performed by one of our cardiologists at any of our affiliated hospitals.

INTERVENTIONAL PROCEDURES

Ablation

Ablation

Arrhythmias are a series of cardiac conditions that affect the electrical system of the heart. Arrhythmias can range from minor inconveniences to life-threatening conditions. Most often, medical therapy or lifestyle changes can be sufficient to control these conditions. However, arrhythmias might require a more complicated treatment to eliminate the electrical short circuits that cause arrhythmias or modify the electrical system to allow for other treatments. These treatments that alter the electrical system are called ablations. Second link here. In an ablation, an electrophysiologist (cardiologist specializing in the electrical system of the heart) will insert catheters into the heart through temporary one-way valves placed into the vines of the legs. These catheters can map out the electrical system of the heart and localize the short circuits triggering the arrhythmia. Once the source of the arrhythmia has been identified, a catheter can be used to destroy the short circuit to prevent recurrences. The ablation only destroys the short circuit involved in the arrhythmia and does not result in damage to the healthy tissues of the heart. The procedure is performed at the hospital under deep sedation or general anesthesia for patient comfort and safety. Topical anesthesia is used to prevent pain at the valve insertion site in the leg. A combination of fluoroscopy (x-ray), ultrasound, and electrical mapping are used to guide the procedure. Some ablations are performed on an outpatient basis and patients return home the same day. Other ablations require overnight monitoring in the hospital. Patients usually experience no side effects from the procedure or mild discomfort at the vein insertion sites. Restrictions following ablation are minimal. Ablation can be used to treat conditions including atrial fibrillation, atrial flutter, SVTs, ventricular tachycardia, and others. Some complex conditions require a more intensive procedure. The CAFC electrophysiology team will work with cardiac surgeons to design a hybrid ablation plan tailored to each individual patient’s needs if such an approach is required. Ablation is performed by the CAFC electrophysiologists at all of our affiliated hospitals though some conditions can only be managed at St. Vincent’s Medical Center or Stamford Hospital.

Angiogram

Angiogram

In situations when warranted, invasive images of the arteries called angiograms are performed. If severe blockages are present then blood flow can be restored using a combination of techniques including wires, balloons, drills, and stents. These procedures can help alleviate symptoms and prevent complications. They are performed in the hospital with fluoroscopy (x-ray) and with sedation for patient comfort.

CardioMems

CardioMems

In patients with advanced heart failure, their conditions lead to increased pressure in the heart that leads to fluid accumulation in the lungs. This fluid makes patients short of breath and frequently requires a hospitalization when medical therapy is unsuccessful. Unfortunately, when a patient is admitted to the hospital with heart failure their risk of complications increases dramatically. Ideally, therapy should be instituted before symptoms begin in order to avoid those high-risk hospitalizations. Often, patients can weigh themselves daily since fluid retention can result in rapid weight gain over short periods of time. However, when this and other strategies do not work, then a small implantable device called a pulmonary arterial manometer can help. This device, also known as a CardioMems, is implanted into the arteries that travel between the right side of the heart and the lungs. The device is inserted via a vein in the leg using conscious sedation for patient comfort and fluoroscopy (x-ray) to guide the procedure. After the skin of the leg has been cleaned and numbed a small one-way valve is inserted into the vein in the groin and the device insertion catheter (tube) is inserted into the lung artery. The device secures itself in place and sends pressure readings to the heart failure team at CAFC through a wireless connection to a monitoring station in the home. If the pressure monitor in the heart shows an elevated value, additional medications can be used to reduce the pressure in the heart before heart failure symptoms or hospitalization occurs. The interventional and electrophysiology teams at CAFC implant the CardioMems device at St. Vincent’s Medical Center and Stamford Hospital. Monitoring is conveniently performed at all of our office locations.

Cardioversion

Cardioversion

In patients who cannot take blood thinners, a mechanical closure of the area most likely to harbor blood clots can be performed. In addition to blood thinners for stroke prevention, AF can be treated with medications to control the heart rate or to keep the heart in a normal rhythm. At times, patients may require a low-risk procedure called a cardioversion to restore normal rhythm.

Coronary Angiogram/Heart Catheterization

Coronary Angiogram/Heart Catheterization

When a patient has a blocked coronary artery (the arteries that supply the muscle of the heart) they may require a coronary intervention to restore blood flow. Direct pictures of your heart are obtained by a specialist cardiologist called an interventional cardiologist. This procedure is called a coronary angiogram or heart catheterization. During this procedure a small IV consisting of a one way valve to prevent bleeding is inserted either into an artery in your wrist or groin. Small tubes called catheters are inserted into that IV and backwards to your heart where contrast (“dye”) is injected into the arteries to take a moving picture which can detect blockages. If blockages occur abruptly, they can result in a heart attack. Heart attacks require immediate attention to limit damage to the muscle of the heart.

EKOS

EKOS

Acute pulmonary embolism (PE) is a common and sometimes fatal disease with a highly variable clinical presentation. It is critical that therapy is administered in a timely fashion to prevent recurrent thromboembolism. Once blood clot such as Deep Vein Thrombosis (DVT) or pulmonary embolism is detected, this catheter-based therapy may be used to treat the problem. During catheter-assisted thrombolysis treatment, a catheter is guided through blood vessels to the location of the blood clot. The catheter will deliver special clot dissolving medicine called thrombolytics to help dissolve the clot. The device, called EKOS is a cutting-edge technology that uses an ultrasound to deliver very low doses of a clot-dissolving drug directly into the clot through a catheter. The result is rapid clearance of the clot while at the same time significantly reducing the risk of bleeding. As ultrasound waves penetrate the clot, it causes the clot to become very porous so when a clot-dissolving drug is infused, it is rapidly absorbed into the clot. The dissolving process is significantly accelerated, resulting in rapid restoration of blood flow.

Implantable Defibrillators

Implantable Defibrillators

Sometimes, the heart can suffer from dangerous arrhythmias from the lower chambers of the heart. Patients with prior heart attacks or weakened heart muscles are at greatest risk as are those who have already had such a problem or those who have certain inherited conditions. Patients might not have any symptoms of these conditions but can suffer from palpitations or passing out. These arrhythmias are very dangerous and can be life threatening. In situations when patients have had a documented arrhythmia or who are at high risk for having one, an implantable defibrillator (ICD) may be required. These devices, like pacemakers, consist of a small computer and battery contained in a sealed sterile container that is inserted just under the skin of the chest near the collarbone and wires that enter the heart itself. These devices are inserted using sedation for patient comfort and using fluoroscopy (x-ray) for safety. ICDs will monitor for arrhythmias as they occur and will treat them using a combination of specialized pacing or with the delivery of an electrical shock to the heart to restore normal electrical function. The physicians of the CAFC electrophysiology team are experts at the insertion and management of ICDs. Monitoring, both remotely from at home and in office, is performed to ensure correct device function and battery longevity. Device insertion can be performed by the CAFC electrophysiologists at all of our affiliated hospitals and monitoring can be performed wirelessly via the CAFC remote monitoring program as well as in most CAFC office locations.

MitraClip

MitraClip

Historically, cardiac surgery was required to repair or replace the diseased mitral valve to prevent heart failure or other conditions. However, mitral valve regurgitation can occur in patients who might not be candidates for cardiac surgery as a result of their age, prior cardiac surgery, other medical conditions, or the function of their heart. In these patients, a less invasive treatment called MitraClip. In this procedure, a specialist cardiologist will repair the mitral valve using a catheter (small tube) inserted through a vein of the leg. After crossing from the right to the left side of the heart, a small clip similar to a clothes pin is used to bring the edges of the mitral valve closer together and reduce the degree of MR. Studies have shown that the MitraClip not only improves symptoms but prolongs life. The structural heart team at CAFC uses a multidisciplinary team to determine who will benefit most from the MitraClip and when it should be performed. This procedure is performed at the hospital under sedation with an anesthesiologist for patient comfort and using a combination of fluoroscopy (x-ray) and ultrasound. What had been a life limiting or fatal condition can now be treated with an overnight hospital stay. The structural heart team at CAFC are leaders in the field of catheter mitral valve procedures and have been performing them since 2015. We are among the highest volume operators in New England. The MitraClip procedure is performed at St. Vincent’s Medical Center.

Pacemaker Insertion

Pacemaker Insertion

At times, the electrical system of the heart can become so diseased that it cannot function normally in a way that is safe for a patient. These conditions can be a result of other diseases or can be a product of aging. Patients with these severe abnormalities of their electrical system can feel fatigued, have shortness of breath with exertion, a decline in their exercise capacity, notice swelling in their feet or legs, or lose consciousness. These conditions are usually diagnosed with electrocardiograms or heart monitors. Once a diagnosis is made, a pacemaker may be required. A pacemaker is a system consisting of a computer and battery in a small, sealed, sterile container that is inserted under the skin of the chest near the collarbone and wires placed into the heart that deliver electrical signals into the heart to help it beat. These devices are usually inserted using sedation to ensure patient comfort and fluoroscopy (x-ray) for safety. Modern pacing has become extremely complex and can serve either to help the heart’s electrical system, help improve the strength of the heart, or both.

Percutaneous Coronary Intervention

Percutaneous Coronary Intervention

If a heart catheterization shows a blocked heart artery, either after a heart attack or in a more stable situation, restoration of blood flow may be required. Restoration of blood flow is called a percutaneous coronary intervention (PCI) and is usually performed at the same time as your diagnostic angiogram through a similar tube inserted through the same IV in your arm or leg artery. Using a combination of tools including wires, balloons, drills and other techniques, your provider will enlarge the blocked artery and will usually implant a stent to keep the artery open. Angiography and PCI are hospital-based procedures performed with sedation for patient comfort and use fluoroscopy (x-ray) to guide the procedure.

PFO Closure

PFO Closure

Strokes mostly afflict older people; in some circumstances, however, strokes can occur in younger individuals without significant risk factors. Such cryptogenic strokes raise a concern for an inherited or congenital cause. When humans develop in the uterus, there is a small connection between the right and left upper chambers of the heart which allow nutrient and oxygen rich blood from the placenta to the developing organs. After birth, there is a strict separation between the arterial side of the heart with high oxygen levels and the lower oxygen levels on the right side of the heart to maximize the efficiency of the heart. To maintain this separation, the connection that exists in the uterus closes after birth. However, this connection remains open in about 15% of adults. When these connections persist into adulthood it is called a patent foramen ovale or PFO. In many individuals, these PFOs cause no problems and do not result in symptoms or complications. However, in a small percentage of patients with a PFO, clots can form within that connection and travel to the left side of the heart and eventually to the brain where they can cause a stroke. In the past, treatments consisted of blood thinners to prevent the clots that cause strokes or cardiac surgery to close the connection between the two sides of the heart. There are risks associated with lifelong blood thinners and cardiac surgery is a major undertaking with risks as well. Now PFOs can be closed using a small device that is deployed within the heart using a catheter. This procedure is performed in the hospital using a small IV placed in the veins of the legs. The procedure is performed under sedation for patient comfort using fluoroscopy (x-ray) and ultrasound to guide the procedure. Studies have shown that this procedure is superior to medical therapy and is far easier to recover from than cardiac surgery. Patients typically return home the same day as the procedure with minimal short-term restrictions. PFO closures are performed by the interventional cardiologists of CAFC at St. Vincent’s Medical Center.

Transcatheter Aortic Valve Replacement

Transcatheter Aortic Valve Replacement

Historically, the treatment for severe aortic stenosis was surgical. Medicines typically do not work for this condition. However, since aortic stenosis is often a disease of aging, surgery is sometimes not an option in an older and more frail population including those who have had cardiac surgery in the past. As a result, many patients were left without a good treatment and left to suffer from progressive symptoms. In April 2002 an aortic valve was replaced through a catheter inserted through an artery in the leg for the first time. Since that time, TAVR has revolutionized the treatment of aortic stenosis in older patients or those who are not healthy enough to undergo cardiac surgery. The procedure is performed in the hospital by an interventional cardiologist specializing in structural cardiac procedures. The structural heart team began performing TAVR in 2013 and has performed several hundred interventions to date. The procedure is performed at the hospital with sedation for patient comfort and uses fluoroscopy (x-ray) to guide the operator. In spite of its complexity, the majority of our patients are discharged home the following day with minimal restrictions. The structural heart team performs TAVR at St. Vincent’s Medical Center and Stamford Hospital.

Watchman

Watchman

For patients who are unable to take a blood thinner due to bleeding or who are at a high risk of complications due to blood thinners including people who fall, the risk of stroke remains the same even if the risk of bleeding is high. In that situation, a mechanical solution to prevent clotting may be required. 90% of the clots that cause stroke in AF come from an area in the left upper chamber of the heart called the appendage. Closing the appendage will prevent blood from pooling thus preventing clots and strokes. This procedure is call a left atrial appendage closure and the most common device used for the closure is called a Watchman. This minimally invasive procedure is performed through a vein in the leg and is not a surgical procedure. Left atrial appendage closure is performed at the hospital with sedation by an anesthesiologist for patient comfort and using fluoroscopy (x-ray) and ultrasound to direct device implantation. Patients are usually discharged home the day after their procedure with minimal limitations. Large clinical trials have proved that left atrial appendage closure reduces the risk of stroke in patients who cannot safely take blood thinners. CAFC’s structural heart team has been performing the Watchman device since 2016 and the physicians on this team are among the highest volume implanters in Connecticut. The Watchman device is performed by members of the CAFC team at St. Vincent’s Medical Center and Stamford Hospital.