Young AFib patient reflects on successful treatment at St. David’s Medical Center

Man and woman with baby son

Five years ago, Ryan Wiseman was in the prime of his life.

“I was thinking I was on top of the world,” Wiseman said. “I was keeping myself in shape. I was taking care of myself mentally and physically. My relationship was solid.”

Then, during a routine medical exam while serving in the military in California, doctors discovered he had Atrial Fibrillation, or AFib.

“Atrial fibrillation is a rhythm disorder of the upper chambers of the heart during which the upper chambers lose the mechanical function, so they don’t contract,” Andrea Natale, M.D., executive medical director of the Texas Cardiac Arrhythmia Institute (TCAI) at St. David’s Medical Center, said.

“Suddenly everything changes, and I’m not able to work out anymore. I may not live as long as I expected,” Wiseman said. “These were all emotional shocks for my wife and me to learn.”

In just five years, Wiseman underwent 10 cardioversions, four ablations and one failed surgery to treat his AFib, but all were unsuccessful.

“After my third ablation, the cardiologist that I have out in Denver, they looked into alternatives to where I could go across the country and they were saying, ‘We’ve done the best we can. We don’t want to take any more risks than we feel comfortable taking. We’re going to send you to the best guy that we have in the country,’” Wiseman said. “So they sent me to Dr. Natale.”

“The typical age of a person with AFib is about late 50s, early 60s, so Ryan is clearly an exception, but this is a genetic disease,” Dr. Natale said. “Unfortunately, because the upper chamber is not contracting, AFib can increase the risk of stroke and heart failure.”

AFib is the most common cardiac arrhythmia, affecting millions of Americans. AFib can cause blood to pool and form clots in the left atrial appendage (LAA). If a blood clot breaks loose, it can travel to the brain, causing a stroke.

Approximately 20 percent of all strokes occur in patients with AFib, and AFib-related strokes are more frequently fatal and disabling. The most common treatment to reduce the risk of stroke in patients with AFib is the use of blood-thinning warfarin medication. Despite its proven efficacy, long-term warfarin medication is not well-tolerated by some patients, and it carries a significant risk for bleeding complications.

As a result, doctors decided to close Wiseman’s LAA mechanically using the WATCHMAN Left Atrial Appendage Closure (LAAC) Device.

The WATCHMAN Implant is a permanent implant designed to close the LAA to keep harmful blood clots from the LAA from entering the bloodstream. By closing off the LAA, the risk of stroke may be reduced, and over time, patients may be able to stop taking warfarin.

“Imagine an umbrella that springs out and closes it,” Dr. Natale said.

“To eliminate my stroke risk and not have to be on blood thinners anymore—that’s huge for me,” Wiseman said. “Being able to go back to running and not having to worry about falling down or somebody hitting me in the chest. I make jokes about it with friends, ‘Hey don’t hit me in the chest. I’m on blood thinners, I might die.’ To a certain degree, it’s kind of funny, but also at the same time it’s a real life-threatening risk that if I fall down some stairs, I may not get back up.”

“This is true for any patient, not just Ryan, but for him, it’s more important because he’s a young parent, so he has to take care of young kids— and at the same time, he has to make sure he can financially provide for his family,” Dr. Natale said. “So it’s actually very important.”

Now, at 32 years of age, Wiseman has bounced back.

“I feel really great, which is an awesome place to be,” Wiseman said. “When you have atrial fibrillation, your heart isn’t pumping as efficiently and, in general, you feel bad. And in general, I feel good—which is awesome.”

The WATCHMAN was approved by the U.S. Food and Drug Administration in March 2015. Texas Cardiac Arrhythmia Institute was involved in clinical trials to study its effectiveness in the United States for nearly a decade, and it was the first facility in Texas to implant the WATCHMAN device in a patient with non-valvular AFib in 2015.

St. David’s Healthcare, an affiliate of HCA Healthcare, is a network of hospitals in the Austin, Texas area. 

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