electrophysio_promo Archives - Pikeville Medical Center

WATCHMAN: A One-Time Implant that helps Reduce AFib Stroke Risk

Jesse Maynard — Fri, 13 Feb 2026 20:06:17 +0000

Marjorie Giovannani's Watchman Story Ingreid Lenz's Watchman Story Billy Stacy's Watchman Story Bill Moate's Watchman Story

How Does AFib Increase Stroke Risk?

The average person with atrial fibrillation (also called AFib or AF) is five times more likely to have a stroke than someone with a regular heartbeat.¹ That’s because AFib can decrease the heart’s pumping capacity by as much as 30%.² Because blood isn’t pumped out of the heart normally, it’s easier for blood cells to stick together and form clots in an area of the heart called the left atrial appendage (LAA).^{2, 3}When a blood clot escapes from the LAA and travels to another part of the body, it can cut off the blood supply to the brain, causing a stroke.^{1, 4}

In people with atrial fibrillation not caused by heart valve problems (the most common type of AFib), more than 90% of stroke-causing clots that come from the heart are formed in the LAA.³

Reducing AFib Stroke Risk

Blood thinners, also called anticoagulants, are an effective way to lower the risk of stroke in people with atrial fibrillation not caused by heart valve problems.⁵ Common blood thinners include warfarin (also known as Coumadin^®), Eliquis^®, Pradaxa^®, Xarelto^® and Savaysa^®.

But some people need an alternative to blood thinners, because they can increase the risk of bleeding.⁵ Some bleeding events are minor and easily treated, like a cut taking longer than normal to stop bleeding. In other cases, the bleeding can be life-threatening, such as when bleeding in the brain causes a stroke.

If you have a history of bleeding or a lifestyle, occupation or condition that puts you at risk for bleeding, your doctor may consider an alternative to blood thinners, such as the WATCHMAN Implant.

WATCHMAN is a permanent implant that offers an alternative to the lifelong use of blood thinners. It’s about the size of a quarter and made from very light and compact materials commonly used in many other medical implants.

How WATCHMAN Works

WATCHMAN effectively reduces the risk of stroke by permanently closing off the LAA to keep blood clots from escaping. WATCHMAN can eliminate the bleeding risks and regular blood tests and food-and-drink restrictions that come with warfarin. In a clinical trial, 9 out of 10 people were able to stop taking warfarin just 45 days after the WATCHMAN procedure.⁶

How is WATCHMAN Implanted?

WATCHMAN is implanted into your heart in a one-time procedure. To implant WATCHMAN, your doctor makes a small cut in your upper leg and inserts a narrow tube, as done in a standard stent procedure. Your doctor then guides WATCHMAN into your heart’s LAA. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.

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Hybrid AF Therapy to Treat Atrial Fibrillation

Jesse Maynard — Fri, 13 Feb 2026 19:50:55 +0000

Atrial fibrillation (Afib, AF) is the most commonly diagnosed abnormal heart rhythm (arrhythmia) in the U.S.:¹

8 million people in the U.S. have Afib¹
2 million people in the U.S. are diagnosed with Afib each year¹
1 in 4 adults will develop Afib in their lifetime²
33 million people around the world have Afib³

Atrial fibrillation is an abnormal heart rhythm caused by erratic electrical signals in the heart. A normal heart rhythm creates regular electrical signals that travel through the heart. The signals are essential for the heart to beat in a steady, rhythmic way. This allows blood to be pumped to all parts of the body. Sometimes the electrical signals become irregular, and the heart beats abnormally.

Atrial fibrillation is also called Afib or AF. If not properly treated, it can grow worse over time and possibly damage your heart. Atrial fibrillation can also lead to health problems:

5x increase in stroke risk⁴

5x increase in heart failure development⁵

Atrial fibrillation also leads to a higher risk of:⁶

Chronic fatigue
Decreased activity level
Decline in quality of life

It’s best to have atrial fibrillation treated before it progresses and causes other health problems.⁷

Even after people develop other heart problems, there is hope. When atrial fibrillation is successfully treated it can:

Reverse the stretching of the left atrium⁷
Improve heart function overall⁷
Improve your symptoms⁸
Reduce the number of heart medications you need⁷

Several medical conditions and risk factors might affect the normal function of the heart, leading to an irregular heart rhythm.

If not properly treated, AFib progresses to more severe stages and can cause damage to the heart.

Medical Conditions

Conditions that may cause people to develop atrial fibrillation include:⁹

Diabetes—The glucose (blood sugar) imbalance that occurs with diabetes can directly affect the tissues of the heart.
Obesity—This puts a person at higher risk for atrial fibrillation.
Sleep apnea—When a person is awakened by lack of oxygen from sleep apnea, it stresses the heart. It can also cause chemical changes inside the heart.
Overactive thyroid gland—When the thyroid is too active, it increases the heart rate.

Risk Factors

Doctors have also identified risk factors that can lead to atrial fibrillation:⁹

Heart attacks
Heart failure
Heart valve disease
Coronary artery disease
High blood pressure
Aging
Family history of atrial fibrillation

Many other factors that can lead to atrial fibrillation, listed below,⁹ are within your control. Talk to your health care provider about how to lead a healthy lifestyle.

Smoking—The risk seems to increase for long-term smokers. But the risk lowers if you quit.
Stress—Emotional stress, including panic disorders, can also put someone at higher risk of atrial fibrillation.
Alcohol—Alcohol consumption, and especially binge drinking, raises a person’s risk.
Caffeine—Caffeine increases the heart rate, which can trigger atrial fibrillation.¹⁰

Trigger Areas for Atrial Fibrillation

There are 3 areas of the heart where atrial fibrillation normally starts. The trigger points are:

The base of the pulmonary veins (PV)
The posterior (back) wall
The left atrial appendage (LAA)

Early Stage of Atrial Fibrillation

Paroxysmal Afib symptoms include:

Palpitations
Fluttering feeling in the chest
Rapid or irregular heartbeat

If not effectively treated, paroxysmal Afib may progress to more advanced stages.

Advanced Stages of Atrial Fibrillation

Persistent Afib
Long-standing persistent Afib
Long-standing persistent Afib affects approximately:¹
- 45% of all AFib patients
- 5 million people in the United States

How Atrial Fibrillation Impacts Your Health

Atrial fibrillation causes physical changes to the structure and shape of the heart.

Scarring: Atrial fibrillation can lead to scarring of the atrial tissue.

Stretching: Eventually the heart tissue becomes stretched, too. As the walls of the heart are stretched, the heart muscle becomes weaker.

Stiffening: The heart muscle gets stiffer, so that it’s harder for the heart to pump properly.

Atrial fibrillation also leads to a higher risk of:⁶

Stroke
Heart failure
Dementia
Chronic fatigue
Decreased activity level
Decline in quality of life
Sudden death

Treatments vary, depending on the stage of atrial fibrillation. Because undertreated atrial fibrillation can progress to more advanced stages, it is very important to talk with your healthcare provider about proper treatment.

Lifestyle Changes

Make exercise and healthy food choices a part of your daily life.
If needed, get a sleep study to find out if you have sleep apnea and need CPAP therapy.

Medications

Medications can help a person in different ways:

Medications can treat blood pressure, diabetes, or an overactive thyroid.
Blood thinners can reduce the risk of stroke.
Rate control medications slow the heartbeat.
Rhythm control medications help control the heart rhythm.

Cardioversion

Cardioversion is done at a hospital or clinic. This therapy delivers a controlled electric shock to the outside of the chest to restore a normal heart rhythm.

If your symptoms continue and are not controlled by medications, your doctor may consider ablation therapy.

The goal of an ablation is to stop the atrial fibrillation, or to make the episodes shorter and less frequent.

Ablation creates lesions, or barriers, on the heart tissue in an effort to stop the erratic electrical signals that cause atrial fibrillation. There are 2 types of ablation:

Endocardial radiofrequency (RF) ablation: Treats the inside the heart—it is most often used to treat paroxysmal atrial fibrillation, an earlier stage of Afib.
Epicardial ablation: Treats the outside the heart

Hybrid AF Therapy combines both types of ablation. It creates lesions inside (endocardial RF) and outside (epicardial) of the heart. Hybrid AF Therapy is used to treat long-standing persistent atrial fibrillation.

Step 1 of Hybrid AF Therapy: Lesions on the Outside of the Heart

Epicardial (outside of the heart) lesions target areas of the heart that cannot be reached from the inside of the heart.

The doctor makes a small 2–3 cm incision under the breastbone.
Once the doctor has access to the heart, lesions are created across the posterior (back) wall.
These epicardial lesions overlap to create a barrier to the erratic electrical signals that cause atrial fibrillation.

tep 2 of Hybrid AF Therapy: Lesions on the Inside of the Heart

Endocardial (inside of the heart) lesions target areas of the heart that are difficult to reach from the outside.

A second doctor makes a small incision in the femoral vein in the upper thigh. This allows access to your heart through the vein.
The doctor looks at an electrical “map” of your heart. It can show any remaining abnormal electrical signals after your first procedure.
The doctor then creates lesions at the pulmonary veins and at any areas that still have abnormal electrical activity.

Your hospital stay will be typically two to three days. Your doctor will:

Prescribe medication to prevent inflammation soon after the procedure
Tell you when you can resume taking needed heart medications
Tell you if you may be able to stop taking certain heart medications

Before you leave the hospital, you will be given a card with important information about your procedure and medications. It also tells you whom to call if you have questions. Keep this in your wallet or purse.

Your healthcare team will tell you when you can return to your daily activities.

The goal of ablation treatment for atrial fibrillation is to stop the irregular heart rhythm or reduce Afib episodes, so that they are shorter and less frequent. This helps the heart return to a more normal size, pump better and improve its function overall.⁷

It may be, but only a health care provider can determine the best treatment for you.

When Hybrid AF Therapy effectively stops atrial fibrillation, there can be other important benefits to the heart:

Reverse the stretching of the left atrium⁷
Improve heart function overall⁷
Improve your symptoms⁸
Reduce the number of heart medications you need to take⁷

Talk to your doctor about how to find the right treatment for your stage of atrial fibrillation.

Colilla, S. et al. (2013). Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. American journal of cardiology, 112(8), 1142-1147.

Lloyd-Jones, D.M., et al. (2004). Lifetime risk for development of atrial fibrillation. Circulation, 110, 1042-1046. doi: 10.1161/01.CIR.0000140263.20897.42

Rahman, F., et al. (2014). Global epidemiology of atrial fibrillation. Nature reviews cardiology, 11, 639-654. https://doi.org/10.1038/nrcardio.2014.118

Benjamin, E.J., et al. (2019). Heart Disease and Stroke Statistics — 2019 Update: A Report From the American Heart Association. Circulation, 139m e56-e528, DOI: 10.1161/CIR.0000000000000659

Odutayo, A. et al. (2016). Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ, 354, i4482.

Calkins, H. et al. (2018). 2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation. Heart rhythm, 14(10):e275-444.

Benussi, S., & de Maat, G.E. (2018). Atrial remodelling and function: implications for atrial fibrillation surgery. European journal of cardio-thoracic surgery, 53(i1):i2–i8, https://doi.org/10.1093/ejcts/ezx340

AtriCure. (2020). PMA P200002 FDA Summary of Safety and Effectiveness Data: Epi-Sense® Guided Coagulation System.

National Institutes of Health. Atrial Fibrillation. Accessed November 2020. Retrieved from https://www.nhlbi.nih.gov/health-topics/atrial-fibrillation.

WebMD. Atrial Fibrillation: Causes, Risk Factors, and Triggers. Accessed December 2020. Retrieved from https://www.webmd.com/heart-disease/atrial-fibrillation/causes-risks-triggers-afib.

Barbarossa, A., et al. (2014). Silent atrial fibrillation: a critical review. Journal of atrial fibrillation, 7(3),
http://www.jafib.com/PMC/XML/Inprogress/1138/1138pdf_federico_guerra.pdf

DeLurgio, D.B., et al. (2021). Hybrid epicardial-endocardial RF ablation vs. endocardial catheter ablation for long-standing persistent atrial fibrillation treatment: Results from CONVERGE randomized controlled trial. International AF Symposium.

Hybrid AF Therapy is for the treatment of long-standing persistent atrial fibrillation.

Risk Information: This procedure is not recommended for patients with Barrett’s Esophagitis, presence of left atrial thrombus (clot), a systemic infection, or an active infection local to the surgical site at the time of surgery (i.e. active endocarditis).

Potential procedural complications include, but are not limited to: Pericardial effusion, pericarditis, infection, cardiac tamponade, pulmonary vein stenosis, vessel injury, tissue perforation, excessive bleeding, phrenic nerve injury, left atrial rupture, esophageal fistula, heart attack, new arrhythmias, thromboembolic complication, stroke/TIA/neurologic complication, complete heart block requiring permanent pacemaker implantation, serious skin burn, a buildup of fluid around your lungs, or death.

This information is not comprehensive. Talk to your health care provider to obtain the FDA-approved product labeling or visit www.AtriCure.com.

Rx Only.

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PMC Among First in Nation to Perform Advanced Novel Atrial Fibrillation Procedure

admin4pmc — Fri, 16 Feb 2024 17:32:24 +0000

Pikeville Medical Center (PMC) performed its first procedure with the Medtronic PulseSelect Pulsed Field Ablation (PFA) System on Thursday, February 15, 2024. The Medtronic PulseSelect Pulsed Field Ablation (PFA) System uses PFA – a breakthrough technology that uses pulsed electric fields to treat atrial fibrillation (AFib) – for the treatment of qualifying patients with paroxysmal or persistent AFib. Recently approved by the U.S. Food and Drug Administration (FDA), Medtronic claims the PulseSelect PFA system effectively, efficiently and safely treats both paroxysmal and persistent atrial fibrillation. Dr. Joseph Souza, an electrophysiologist at PMC’s Heart and Vascular Institute of Eastern Kentucky, was one of the first physicians in the nation to utilize this technology.

AFib is a progressive condition that affects nearly 60 million people worldwide. Without early intervention, AFib can progress, becoming more sustained over time. Progression of AFib is associated with a higher rate of cardiovascular admissions, heart failure, stroke and mortality, along with a reduced quality of life.

PulseSelect

The PulseSelect PFA system delivers pulsed electric fields through an ablation catheter designed specifically to interrupt irregular electrical pathways in the heart that trigger AFib. Current ablation technologies rely on thermal effects to target cardiac tissue and risk damage to additional collateral structures in the heart. PFA is a breakthrough ablation technology that uses pulsed electric fields to isolate the pulmonary veins for the treatment of AFib efficiently. Because the mechanism of cell death is non-thermal, the risk of collateral structure damage is believed to be lower.

“AFib is an ever-growing cardiac concern worldwide, and we see especially high rates in our region. Because of this, we have more patients than ever coming in looking for treatment,” said Dr. Souza. “The PulseSelect PFA system can provide patients with a treatment option that may have less risk of causing unwanted injury to surrounding tissues like traditional ablation technologies – helping physicians put patient safety first. We are pleased to have treated our first patient with this new technology, and we look forward to helping advance the future of AFib treatment by offering innovative solutions to the people of Central Appalachia.”

PMC is a leader in heart care, and as such, continuously searches for new and advanced treatment options.

“As we look to improve cardiovascular care in the region, PMC strives to utilize the latest technological innovations that meet the needs of our patients and our physicians,” said PMC Chairman, President and CEO Donovan Blackburn. “This is a growing patient population, and we must keep looking for ways to provide them with the best care possible. This is a monumental step forward in the right direction.”

To learn more or to schedule an appointment at the Heart and Vascular Institute of Eastern Kentucky at Pikeville Medical Center, call (606) 430-2201.

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