MDNews - Long Island

The WATCHMAN Procedure: Unique to Queens SOMETIMES, THE BEST solution to a cardiac problem is an elegant, structural procedure. This is the case with the WATCHMAN proce- dure, which helps patients who have atrial fibrillation reduce their risk of stroke. Patients with atrial fibrillation are at risk of stroke due to the fact that blood clots may form in a small appendage of the heart and then be pushed out and travel to the brain. Typically, these patients are treated with blood thinners such as warfarin or one of the newer anticoagulant agents. But that anticoagulant has significant downsides: Patients must have regular blood work (if they are taking warfarin), and there is always a risk of bleeding. Some patients are unable to take blood thinners due to problems with bleeding such as intestinal bleeding, bleeding within the brain, or due to the high-risk nature of their profession. The WATCHMAN opens up additional treatment options for such patients, explains David Slotwiner, MD, FACC, FHRS, Chief of the Division of Cardiology at NewYork-Presbyterian Queens and assistant professor of clinical medicine at Weill Cornell Medicine. Named after the WATCHMAN device, the procedure closes off the left atrial appendage, reducing patients' risk of stroke and eliminating the need for the patient to take life-long blood thinners. "It's a very elegant procedure," Dr. Slotwiner says. "There is a small pouch in the upper left chamber of the heart where blood can pool and form clots, and those can move to the brain, caus- ing stroke. [To close off the chamber] we place this device via a catheter from a vein in the leg. Using X-ray guidance, we direct it to the heart, where it acts as a plug in the opening of the pouch, sealing the opening so blood can no longer enter or exit." The procedure takes about an hour and is performed under general anesthesia, Dr. Slotwiner says. Patients return home the following day. After about 45 days, he adds, the heart has healed and patients no longer need blood thinners. NewYork- Presbyterian Queens is the only hospital in the borough offering the WATCHMAN surgery and device. "Our procedure is unique to the area," Dr. Slotwiner says. "We are very proud of it." David Slotwiner, MD, FACC, FHRS, Chief of the Division of Cardiology at NewYork-Presbyterian Queens and assistant professor of clinical medicine at Weill Cornell Medicine, speaks with a patient. David Slotwiner, MD, FACC, FHRS CHIEF OF THE Division of Cardiology at NewYork-Presbyterian Queens, Dr. Slotwiner is an electrophysiologist who received his medical degree from the University of Chicago Pritzker School of Medicine. He completed his residency at NewYork-Presbyterian/Weill Cornell Medical Center. He also performed two fellowships, in cardiology and cardiac electrophysiol - ogy at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. Dr. Slotwiner is board certified in internal medicine, cardiovascular disease and clinical cardiac electrophysiology. He is a member of the American College of Cardiology, the Heart Rhythm Society and the American Medical Association. Dr. Slotwiner is an assistant professor of clinical medicine at Weill Cornell Medicine. He divides his time between clinical practice, teaching and working with the FDA on medical device safety and surveillance, development of registries, and health informatics related to data standards and interoperability. low complication and morta lity rates, Dr. Lang adds. This results in high-quality care and patient satisfaction. DETAILED INFORMATION Before surgeons, interventional cardi- ologists or cardiac electrophysiologists perform any cardiac procedure, each patient undergoes diagnostic services tai- lored to his or her overall circumstances. NewYork-Presbyterian Queens offers advanced cardiac screening and diagnos- tic tests, including cardiac CT and MRI, calcium scanning, 3-D transesophageal echocardiogram, nuclear stress testing and the full complement of arrhythmia screening tools. Imaging and testing systems guide physicia ns t hroug hout t he prog res- sion of a patient's diagnosis, treatment and recovery. "A prima r y ca re physicia n or ca r- diologist might hear a heart murmur during examination of the patient, or the patient might experience chest pain or shortness of breath," says Gregor y P o n t o n e , M D, FA C C , D i r e c t o r o f Outpatient Cardiovascular Services and Co-director of Inpatient Cardiac Imaging at NewYork-Presbyterian Queens. "They might send the patient for further imaging, including an echocardiogram, to deter- mine whether there's a valve problem or stress testing to identify blockages in the arteries that supply the heart." Stress testing may be done via exercise or a medicine that stresses the heart; in either case, imaging taken under stress may help identify areas of decreased blood M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 017 0 7

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