A patient experiencing Atrial Fibrillation (AFib) symptoms such as palpitations, fatigue, and shortness of breath was referred to the 3DQ Lab for imaging and evaluation for Watchman Device implantation. These symptoms indicated a disrupted heart rhythm and elevated stroke risk, making the patient a potential candidate for the procedure. Using computed tomography (CT) scans, the 3DQ Lab was able to create a detailed view of the patient’s heart structure, including the left atrial appendage (LAA) where blood clots are most likely to form. The imaging was used for determining the suitability and precise placement of the Watchman Device, a medical implant designed to reduce the stroke risk of AFib patients by sealing off the LAA.
What is Atrial Fibrillation?
Atrial fibrillation (AFib) is a heart condition defined by irregular and often rapid contractions of the upper chambers (atria) of the heart. This irregular rhythm disrupts the flow of blood through the heart, increasing the risk of clot formation. These clots commonly form in the left atrial appendage (LAA), a small, ear-shaped pouch in the left atrium. The LAA is particularly prone to blood stagnation, making it a hotspot for clot formation in AFib patients. These blood clots have the potential to break free from the LAA, travel through the bloodstream, and cause a stroke if they reach the brain.
Figure A (Right): An Electrocardiogram (ECG or EKG) creates a visual representation of a patient’s heartbeat pattern and is used to diagnose AFib.
How does a Watchman Device work?
The Watchman Device functions by sealing off the left atrial appendage, reducing the risk of blood clots and stroke. To install the device, a catheter is inserted into a vessel in the groin and navigated through the vascular system to the heart, where the device is deployed to block the LAA. Once implanted, the Watchman Device acts as a physical barrier that seals off the LAA, preventing blood clots from escaping. Over time, heart tissue grows over the device, fully integrating it into the heart’s structure. This eliminates the need for long-term anticoagulant medication, which can have unwanted side effects.
Figure B (Right): An illustration of a Watchman device sealing off the left atrial appendage.
Role of 3D Imaging
A Computed tomography (CT) scan was obtained of the patient’s heart and was needed for the planning and execution of Watchman Device implantation. Using the CT scan, a 3DQ Lab technologist was able to create detailed images of the heart’s structure, specifically the size and shape of the LAA. This information was crucial for selecting the appropriate size of the Watchman Device and ensuring accurate placement, thereby increasing the procedure’s effectiveness and safety. Below are the images the 3DQ Lab created for this case:
Figure C – Watchman Measurements: Sizing measurements for the Watchman device determine effective placement and fit.
Figure D – Fluoroscopy Planning: A visual representation of the path a catheter may take through the heart during installation of the Watchman device.
Figure E – A horizontal rotational reconstruction of the patient’s left atrium.
Figure F –A vertical rotational reconstruction of the patient’s left atrium.