Is it safe to have an MRI with the WATCHMAN left atrial appendage closure device?

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Yes, it is safe to have an MRI with the WATCHMAN Left Atrial Appendage Closure Device, because the device is classified as MR Conditional.

This means you can safely undergo an MRI scan, but your medical team must follow specific safety conditions based on your exact device model (such as the original WATCHMAN, WATCHMAN FLX, or WATCHMAN FLX Pro).

Important Safety Steps

  • Bring your implant card: Your WATCHMAN Implant Card lists your specific device generation and model number.
  • Inform your healthcare team: Always tell your doctor, nurse, and MRI technologist that you have a WATCHMAN Device before the procedure. Show them your implant card so they can verify the exact scanning conditions (such as magnetic field strength or scan time limits).
  • Need a replacement card? If you lost your card, you can contact Boston Scientific patient support to request a new one.

What can you not do with a Watchman device?

You cannot use the WATCHMAN Implant to cure atrial fibrillation (AFib) or control your heart rhythm.

What the WATCHMAN Device Cannot Do

  • Cure AFib: The device does not treat or stop the underlying heart rhythm disorder.
  • Control Heart Rhythm: It contains no batteries, wires, or electronic components to regulate heartbeats.
  • Replace All Medications Immediately: You must still take blood-thinning medications for a short healing period (usually at least 45 days) after the procedure until tissue grows over the implant.
  • Limit Long-Term Movement: Once fully healed, the device does not restrict physical activity, exercise, or routine daily life.
  • Trigger Metal Detectors: The implant will not set off airport security systems or metal detectors.

How long does it take to recover from a left atrial appendage closure procedure?

Recovery from a minimally invasive left atrial appendage closure (LAAC) procedure typically takes about one to two weeks for normal daily activities, with most patients going home the same day or the following morning.

Immediate Hospital Recovery

  • Time in hospital: Most patients stay for a few hours of monitoring or spend one night in the hospital.
  • Initial rest: You will need a short period of bedrest right after the catheter tubes are removed from your groin.

First Few Days at Home

  • Light activity: You can do easy walking or light housework within 24 to 48 hours, but you should rest when tired.
  • Restrictions: Avoid heavy lifting (over 10 pounds), strenuous exercise, and straining for the first 1 to 2 days (or as directed by your doctor).
  • Wound care: Keep the catheter insertion site clean and dry. You can usually shower after 24 to 48 hours, but avoid soaking in a tub or pool for one week.
  • Site healing: Minor bruising, tenderness, or a small lump at the puncture site is normal and usually fades within 2 to 4 weeks.

Long-Term Healing and Follow-Up

  • Tissue growth: It takes about 45 to 90 days for your heart tissue to completely grow over the permanent implant.
  • Medications: You will likely need to take prescribed blood-thinning or anti-clotting medications during this healing phase until your doctor confirms the closure is complete.
  • Follow-up: Expect imaging appointments (such as an echocardiogram) around 45 days to 6 months post-procedure to check your progress.

For more details on managing your recovery safely, see this guide on Left Atrial Appendage Closure aftercare.

Can I have an MRI if I have a watchman?

Yes, you can have an MRI if you have a WATCHMAN device, because the implant is classified as "MR Conditional."

Safety Conditions

  • Safe under specific limits: The device is safe to scan under specific magnetic field strengths (such as 1.5T or 3.0T) and energy limits determined by the manufacturer.
  • Check your implant card: The exact safety rules depend on your specific device generation, which is listed on your WATCHMAN Implant Card.

What You Should Do

  • Inform your care team: Tell your doctor and the MRI technologist about your WATCHMAN implant before scheduling or starting the scan.
  • Bring your card: Show your WATCHMAN Implant Card to the imaging staff so they can verify the correct safety guidelines for your device model.
  • Call if lost: If you do not have your card, contact Boston Scientific Device Support at (855) 637-9428 to get your device information before your appointment.

Is a left atrial appendage closure the same as a watchman?

Yes, a left atrial appendage closure (LAAC) is the general name for the procedure, and the Watchman is a specific brand of device used to perform it.

The Difference Explained

  • Left Atrial Appendage Closure (LAAC): This is the overall medical term for any procedure that seals off the left atrial appendage (a small pouch in the heart) to stop blood clots from forming there. Other devices can also do this, such as the Amplatzer Amulet or surgical options like the AtriClip.
  • Watchman: This is the most well-known, FDA-approved implantable device used during a left atrial appendage closure procedure. It is a tiny, umbrella-shaped plug put into the heart through a tube in your leg.

Why the Procedure is Done

  • It helps patients with atrial fibrillation (an irregular heartbeat) lower their risk of stroke.
  • It serves as an alternative for people who cannot safely take long-term blood thinners due to bleeding risks.
  • You can read more about the approach on the Watchman Information Page.

Decreasing Risk of Stroke with the WATCHMAN Device | Duke Health

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Is it safe to have an MRI with a WATCHMAN LA closure device?

Yes, it is safe to have an MRI with a Watchman device, but the implant is classified as MR Conditional rather than universally unrestricted. This means an MRI is safe as long as the imaging facility follows specific rules based on your exact device model.

What You Need to Do

  • Bring your implant card: Your wallet card lists your specific device generation (such as original Watchman, FLX, or FLX Pro).
  • Tell your medical team: Inform the doctor and MRI technologist about your device before the scan. Show them your implant card so they can verify the correct scanner settings.
  • Review official guidance: You can read more details through the Boston Scientific WATCHMAN MRI Support page.

Safety Details for the Facility

  • Scanner strength: The device is compatible with standard 1.5-Tesla and 3.0-Tesla MRI machines.
  • Scan time limits: Implants placed before 2022 may require continuous scan times to be limited to 15 minutes.

What is the new alternative to the Watchman?

The primary established alternative to the Boston Scientific Watchman device for left atrial appendage closure (LAAC) is the Amplatzer Amulet by Abbott, while newer investigational options like the AnchorMan device are also showing promising clinical trial results.

Key Alternatives

  • Amplatzer Amulet: This is the most direct commercial competitor to the Watchman FLX. It features a dual-seal design (a lobe and a disc) suited for a wider variety of heart anatomies and allows immediate discharge without mandatory oral anticoagulants in certain protocols.
  • AnchorMan Device: A newer, investigational left atrial appendage closure device that recently published one-year data showing non-inferiority to the Watchman 2.5 system.
  • Lariat Device: An alternative epicardial ligation tool that uses a suture from the outside of the heart to tie off the appendage, rather than an internal plug.

What is the success rate of left atrial appendage closure?

The procedural success rate for implanting a minimally invasive Left Atrial Appendage Closure (LAAC) device is approximately 95% to 98.5%, meaning the device is successfully placed in the vast majority of patients.

However, the "success rate" varies depending on whether you mean placing the device, achieving complete closure over time, or performing the procedure surgically.

Minimally Invasive Device Implantation (Catheter-Based)

  • Procedural Success: Around 95% to 98% for modern endocardial plug devices (like Watchman or Amulet). This measures successful deployment and release of the device during the procedure.
  • Complete Sealing: Over 90% to 95% of patients achieve complete or near-complete closure (residual leaks under 3–5 mm) confirmed via follow-up imaging like a transesophageal echocardiogram (TEE).
  • Stroke Risk Reduction: Studies show these devices reduce the relative risk of ischemic stroke significantly compared to no treatment, matching the long-term efficacy of standard blood-thinners for non-valvular atrial fibrillation.

Surgical Left Atrial Appendage Closure (During Open or Robotic Heart Surgery)

  • Excision or Clipping: Surgical removal (excision) or using a specialized epicardial clip (such as an AtriClip) has a high closure success rate of 70% to over 90%.
  • Traditional Suture/Ligation: Older or alternative surgical techniques (like simple hand-sewing or basic ligation sutures) historically showed lower or highly variable long-term success rates, ranging from 23% to 64%, due to the risk of gaps or re-opening over time.

What is the average life expectancy after the Watchman procedure?

There is no specific "average life expectancy" number after a Watchman procedure because the device itself does not determine how long a person will live; rather, life expectancy depends heavily on a patient's age, overall health, and underlying conditions.

Patient Profile and Life Expectancy

  • Typical Age: Most patients who receive a Watchman Implant are older adults, with a median age around 75 to 77 years.
  • Underlying Health: Because these patients often have atrial fibrillation (AFib) and cannot tolerate blood thinners due to a high risk of bleeding, they frequently live with other serious medical conditions.
  • Survival Data: Large studies on older populations (such as Medicare beneficiaries) show a cumulative mortality rate of about 8% to 10% per year following the procedure, largely driven by baseline health risks rather than the implant itself.

Longevity of the Device

  • Permanent Solution: The Watchman device is designed to last a lifetime once it is successfully placed inside the heart.
  • Stroke Reduction: It permanently seals off the left atrial appendage to prevent blood clots, lowering long-term stroke risks without changing a patient's general life expectancy baseline.

What are the risks of a left atrial appendage closure device?

A left atrial appendage closure (LAAC) device carries procedural, short-term, and long-term risks, including bleeding, fluid buildup around the heart, and blood clots on the device.

Procedural and Short-Term Risks

  • Bleeding: Minor bleeding or bruising can happen at the catheter insertion site in the groin, though major internal bleeding is also possible.
  • Pericardial Effusion: Fluid can build up in the sac surrounding the heart, which may lead to cardiac tamponade (pressure on the heart requiring urgent drainage).
  • Device Embolization: The device can shift, move out of place, or travel into the heart chambers or blood vessels, requiring retrieval.
  • Vascular Damage: Large tools used during the procedure can harm blood vessels in the groin or cause blood vessel blockages and pseudoaneurysms.
  • Stroke or Air Embolism: An air bubble or a loose blood clot can enter the bloodstream during catheter movement and trigger a stroke or transient ischemic attack.

Long-Term Risks

  • Device-Related Thrombus (DRT): Blood clots can form directly on the surface of the implanted device, which can increase the risk of a stroke.
  • Peri-Device Leak: Incomplete sealing can leave a small gap around the device, allowing blood to flow into and out of the appendage and potentially cause clots.
  • Erosion or Tissue Damage: Over time, the device can cause wear or damage to nearby heart tissue or adjacent blood vessel structures.
  • Infection: An infection can develop at the initial access site or spread to the heart implant itself.
  • Allergic Reaction: Some patients may experience a sensitivity or allergic reaction to the materials inside the device, such as nitinol (nickel-titanium).

For comprehensive details on specific options, you can review the Cleveland Clinic Guide to LAA Closure.