Switching to Watchman

On a warm summer day in 2017, Joseph Rogalski Jr. went for a walk with his dog. He was only a block from home when he suddenly dropped the leash.

“I didn’t understand why I dropped it, but when I tried to reach it, I had trouble grabbing it. I got dizzy,” says Joseph.

Despite feeling disoriented, he was able to walk back home with his dog. Joseph’s husband immediately noticed something was wrong and called 911. Within 15 minutes, the ambulance arrived and Joseph was taken to a nearby hospital.

He had a stroke caused by atrial fibrillation (AFib).

AFib and anticoagulants
Joseph was diagnosed with AFib, a type of irregular heartbeat, 17 years ago. A person with AFib is five times more likely to have a stroke compared to someone without AFib. To decrease the chance of stroke, some patients are given blood thinners, which prevent blood from coagulating and forming clots that can block blood flow to the brain, leading to a stroke.

Initially, Joseph was prescribed warfarin, but eventually chose to stop taking this blood thinner due to side effects, such as fatigue. Instead, he took baby aspirin to keep his blood from thickening, as well as other medications to control the AFib.

Switching to Watchman
On that summer day in 2017, Dr. Dimitri Sherev, an interventional cardiologist affiliated with Sharp Grossmont Hospital, was the doctor who treated Joseph for stroke. Joseph spent a week in the hospital, followed by three weeks in inpatient rehabilitation for physical and speech therapy.

During follow-up appointments, Joseph and Dr. Sherev discussed options for preventing future strokes caused by AFib. At the time, Joseph was taking another blood-thinning medicine.

Instead of medications, Dr. Sherev recommended the Watchman procedure. During this procedure, a surgeon inserts a device to seal the heart’s atrial appendage — a pouch where blood can sometimes collect. For patients with AFib, the heart has a difficult time pumping blood out of the atrial appendage, so the blood coagulates, increasing one’s risk for stroke.

“Given his high risk for bleeding based on his age, as well as other medical problems, Joseph was an ideal candidate for the Watchman procedure,” says Dr. Sherev.

Joseph gave it some thought, and in 2019 he decided to move forward with the procedure.

“Weighing the benefits and risks of Watchman, I would rather have the procedure than stay on medications for the rest of my life. And if having Watchman meant having one less pill to take a day, well that would be great.”

Another reason Joseph opted for Watchman was the ability to get medical help immediately, if needed.

“If a medical emergency happened, like if I needed to have surgery, I wouldn’t have to wait for a period of time to have my blood-thinning medications leave my body, before getting any treatment done,” says Joseph.

Adds Dr. Sherev, “Joseph has had a prior stroke, and any future interruption of blood thinners will predispose him to another stroke. For example, if he had to stop taking a blood thinner in order to have any future procedure, such as a colonoscopy, dental work and so on.”

Dr. Sherev performed the Watchman procedure at Sharp Grossmont’s state-of-the-art Burr Heart & Vascular Center.

Since his stroke, Joseph has regained his ability to walk and speak. He still gets tired once in a while, due to the AFib, and occasionally has tingling in his limbs. But, he feels that he is getting his strength back and is able to live with AFib. He’s happy that he does not need to take extra medications to address the stroke risk that comes with it.

Learn more about heart and vascular care at Sharp Grossmont.