Tampa General Hospital

B ob Icenogle gets up at 4:30 a.m. every morning. He's usually at his favorite breakfast joint by 5:30 and then heads over to his business, Dollar a Day Storage, in Ruskin. "I stay busy and I keep my mind busy, so I don't think about aches and pains," says Icenogle, 69. A former inventor and patent holder in the marine industry, Icenogle has worked hard since he was 14. Staying healthy enough to stay busy is why Icenogle was interested in a new device in use at Tampa General Hospital for people with conditions like his. Icenogle's irregular heartbeat, or atrial fibrillation, puts him at higher risk for stroke. But his body doesn't easily tolerate blood thinners, one of the most common ways to lower stroke risk. "If I take them, I hemorrhage," he says. "One week I had seven transfusions. I leak like crazy." That's why Icenogle became the first Tampa General patient to get a new device, called the WATCHMAN™, implanted in his heart earlier this month. The WATCHMAN is intended to lower stroke risk by preventing the blood clots that often cause them. Oxygenated blood from the lungs comes through the heart's left atrium, is pushed out into the left ventricle, then travels throughout the body. But in atrial fibrillation, the heart's irregular beats mean that blood isn't pumped out of the heart as swiftly as it should be. Inside the left atrium, those irregular beats could result in blood pooling in a small pouch-like area called the left atrial appendage. Once the blood pools, it can form clots, which can then break loose, travel to the brain and cause a stroke. "That space is notorious for the forma- tion of clots," says Bengt Herweg, MD, director of electrophysiology and arrhythmia services at USF Health and Tampa General Hospital's Cardiovascular Center. Dr. Herweg and his colleagues, Umesh Gowda, MD, and J. Thomas Sullebarger, MD, performed Icenogle's WATCHMAN procedure. The WATCHMAN is a quarter-sized mesh net that covers the appendage. Once it's implanted, cells from the inside lining of the heart gradually cover the device, sealing off the appendage so that blood can't clot inside it. "It's like closing off a hazardous area," Dr. Herweg says. Doctors implant the WATCHMAN by making a puncture in the patient's leg and inserting a tube, or catheter, inside the vein to guide the WATCHMAN device to the heart. Patients usually need about 24 hours to recover from the procedure and must take blood thinners for several weeks afterward to give time for tissue to grow over the implant and seal off the appendage. Once that occurs, patients have a lower risk of stroke without taking blood thinners. "It will give us new options for patients on blood thinners who are unable to tolerate them and will make a major impact on these patients," Dr. Herweg says. Icenogle got the device on a Thursday and was back at Dollar a Day Storage by Monday. "Other than being a little weak, I'm in fine shape," he says. "It may not be for everybody, but for somebody in my situation, I think I was a prime candidate." HEART FOR MORE INFORMATION ABOUT THE WATCHMAN DEVICE AT TAMPA GENERAL, CALL 813-844-5072. More than 795,000 people have a stroke every year in the United States. Most of them have never had a stroke before. African Americans are almost twice as likely as Caucasians to have a stroke. Nearly half of all Americans have at least one risk factor for stroke, including high blood pressure, high cholesterol and smoking. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, ONE IN 20 DEATHS IN THE U.S. IS CAUSED BY STROKE. EDUCATE YOURSELF ABOUT HOW TO PREVENT STROKE WITH THESE FACTS. 2x The WATCHMAN ™ implant is about the size of a quarter. Patients who receive medical aention within the first three hours of a stroke have less disability three months aer treatment. Keeping alcohol consumption to no more than two drinks per day for men and one drink for women can help keep stroke risk low. 15 summer 2016 / tgh.org

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