Avera Medical Minute: Doctors use innovative approach to help atrial fibrillation patient

YANKTON, S.D. (Dakota News Now) - Atrial fibrillation is a condition that causes the heart to beat out of rhythm and can put patients at a higher risk for stroke. Medications can help correct the problem, but in some cases can cause some side effects.

A Yankton man’s complex medical history forced his doctors to think outside the box and take a groundbreaking approach to deliver his care.

This isn’t the first time Clarence Hauger has been seen by a doctor, but he’s hoping it’s the last for a while. Clarence has atrial fibrillation, and he’s kept it in check by taking a blood thinner. But recently, that medication has caused some severe side effects.

“I had a big bleed, ended up in the hospital,” said Hauger.

“Well, it was scary, and it went so fast, so we didn’t realize how much he was bleeding either,” said Rose Hauger, Clarence’s wife.

Those blood thinners were causing Clarence to bleed very easily from any bump and bruise. When you have atrial fibrillation, your heart beats out of rhythm, and because of that, there’s a tendency for blood to pool and clot inside the upper chambers of the heart. That clotting factor can put you at a high risk for a stroke. Clarence’s next option was an implanted device to keep his heart in check.

“A Watchman is a device that allows us to try to make the risk of stroke low, but it also has the benefit of getting people off the blood thinners, so they don’t have bleeding complications,” said Dr. John Wagener, an interventional cardiologist with the North Central Heart Institute.

The Watchman device is designed to prevent blood from pooling and clots from forming. When assessing patients for a watchman device, doctors first do an echocardiogram by passing a probe through the esophagus, which proved to be a challenge for Clarence.

“17 years ago, he had his esophagus removed for cancer in the esophagus,” said Rose Hauger.

“A year ago, we would have had to say, ‘Sorry, the only way to prevent stroke, at least here locally, would be to continue taking your warfarin,’” said Dr. Wagener.

But Clarence’s rather complex medical history was only a small hurdle thanks to a newly approved approach for delivering the Watchman device.

“The cardiology community has come up with an intracardiac echocardiogram that has the ability to do 3D rendering of the left atrial appendage, so we can both size the left atrial appendage and make sure that somebody is a candidate for Watchman without having to do a trans-esophageal echocardiogram. In addition, when we do the procedure to make sure we’re putting it in the right place, we can monitor the left appendage using the same intracardiac echo to make sure we have a good result,” said Dr. Wagener.

With a Watchman in place, Clarence shouldn’t need a blood thinner to prevent a stroke, and with the success of his unique and cutting-edge procedure, there’s a potential to impact even more patients struggling with atrial fibrillation.

“This is the first time anybody in South Dakota has been able to do this, but I think it’s important that the medical community here in South Dakota continues to bring these more leading-edge technologies to help our patient population, as well as expand access to people who would otherwise not be able to have this done for them,” said Dr. Wagener.

For Clarence and Rose, with this little bump in the road behind them, they’re ready to get back to enjoying life with a little less stress.

“We keep busy!” said Clarence Hauger.

“Absolutely! We were very, very happy for Dr. Wagener!” said Rose Hauger.

The Avera Heart Hospital was the first in the region to offer The Watchman Device to patients in the fall of 2016. This new approach for delivery is just the latest example of cutting-edge practices being put to use and improving patient outcomes.

For more information on the Watchman Device and Atrial Fibrillation resources, visit Avera.org/medicalminute.

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