Question:

In treating atrial fibrillation, how does one decide between the Watchman procedure vs. the Lariat procedure? 

I had a heart attack in 2014 and severe afib and rectal bleeding in 2015. Because of the bleeding, which we can’t seem to find the source, I cannot take blood thinners other than low dose aspirin. My doctor has suggested the Watchman procedure, but I’ve also been reading about the Lariat. Can you recommend one over the other should I elect to get one of them done.

Submitted by Dee from Crystam River, Florida on 11/04/2017

Answer:
by Abdi Rasekh, MD

Watchman requires 45 days of anticoagulation therapy post-implant. With Lariat, you do not need short-term anticoagulation therapy. However, not everybody is a good candidate for Lariat. If you had previous bypass or radiation therapy to the chest, you would be excluded. Furthermore, a CT angio of left atrial appendage is required to see if the patient has favorable anatomy for the Lariat implant.