Ablation v Watchman as a cure for A/Fib and A/Flutter.


I had a pacemaker fitted in Juine last year due to my heartbeat going down to 29 at times. The procedure has been a success, however I am still getting A/Fib and Flutter and my original consultant wanted to do an Ablation. He had a problem in that he wanted to give me anti-coagulents but was not able to until my platelet count could be lifted from a current 30ish to 50+. My Haematologist was not keen to play ball so I reached an enpasse. In order to try to break the empasse I moved my Cardiac treatment to the same hospital as my haemotology, and was amazed to find a totally different thought. One consultant wanted to treat with betablockers (Bisiprolol) which after 5 days had plummeted my platelets to 20. He then sought further advice up the line and the "Watchman" procedure was suggested (plugs a pocket in the heart to prevent clotting) That surgeon said that it was the best option to prevent strokes and that an Ablation would not worl as I had had the A/fib for a year or two. I am 76 and don't particularly want a full anaesthetic as required for the "Watchman".

Has anyone any thoughts on these procedures. 



by Tracey_E - 2019-03-07 11:05:04

Do your homework and consider it very carefully before proceeding with a Watchman. They are new with an iffy track record. I know two people, one of whom is a medical professional, who looked into it based on their doctor's recommendation, both decided against it. 

Ablation & Watchman

by AgentX86 - 2019-03-07 14:18:19

The watchman is a reasonable option for any who can't take anticoagulants for some reason. I had my LAA (left atrial appendage), the "pocket" that you refer to, closed during open-heart surgery. This reduces the chance of stroke by something like 90% but it doesn't eliminate it. I still have to be on anticoagulants for the test of my life.

A pacemaker is very unlikely to help with AF or AFL but it will fix Bradycardia, which can be caused by many of the drugs used to treat AF and AFL.

As far as an ablation goes,  having afib for a couple of years doesn't necessarily mean an ablation won't work but your odds are worse. I'd go to the best ablation EP that you can find and let him give you the options.

There is a lot more information about ablations and the Watchman on "stopafib.org".

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