Skip to cookie consent Skip to main content

Home Hospital Program Supports Recovery After Treatment for Atrial Fibrillation

5 minute read
Senior man and women standing in a field near the ocean
Alan Horwitz and his wife, Susan

Alan Horwitz has always prided himself on staying in shape. At 85, the retiree keeps active golfing, lifting weights, and riding his recumbent bike. In his younger days, he ran 18 marathons—including one in just under three hours.

Six years ago, Alan was diagnosed with a condition that threatened to slow him down. Atrial fibrillation (AFib) is an abnormal heart rhythm (arrhythmia) that causes the organ to beat irregularly, often too quickly. It increases the risk of blood clots, which can cause a stroke if they travel to the brain.

At the time, Alan underwent cardiac ablation for AFib. During this minimally invasive procedure, doctors guide thin wires up to the heart to create lines of scar tissue that separate abnormal signals from the rest of the heart tissue. He was then placed on blood thinners to reduce the risk of blood clots. But the medication had a dangerous downside: Whenever he banged a knee or skinned an elbow, he experienced a great deal of bleeding.

More recently, Alan had several falls. That concerned his Mass General Brigham Heart and Vascular Institute cardiologist, Jagmeet Singh, MD, PhD. If Alan were to hit his head, his next fall could be deadly. Dr. Singh said that a device called a Watchman would eliminate the need to take blood thinners, thus guarding against the threat of excessive bleeding.

Alan eventually had the Watchman implanted during a procedure at Massachusetts General Hospital. Hours later, he was able to go home, where he received hospital-level care via Mass General Brigham Home Hospital.

"I don't know what's so glamorous about staying in the hospital overnight," he said. "I was thrilled to be at home and to know I was in good hands. It was a luxury."

We take a very comprehensive approach to treating AFib. We always keep up with new breakthroughs in AFib and offer all the latest treatments, including investigational devices and drugs via clinical studies.

E. Kevin Heist, MD, PhD

Mass General Brigham Heart and Vascular Institute

Mass General Brigham offers all the latest AFib treatments

Alan clearly values long-term relationships. He has been a Mass General patient for 50 years and married for over 40 years. He and his wife, Susan, have three adult children and six grandchildren.

To explore the possibility of a Watchman implant, Dr. Singh referred Alan to E. Kevin Heist, MD, PhD, a colleague at Mass General Brigham Heart and Vascular Institute. Like Dr. Singh, Dr. Heist is also part of Mass General Brigham's Cardiac Arrhythmia Program.

"We take a very comprehensive approach to treating AFib," Dr. Heist said. "We always keep up with new breakthroughs in AFib and offer all the latest treatments, including investigational devices and drugs via clinical studies."

The Watchman, one of many treatment options available through the program, is a U.S. Food and Drug Administration–approved therapy designed to replace blood thinners and prevent strokes in patients with AFib. Mass General Brigham was involved in early clinical trials of the Watchman in the mid-2000s and has contributed to the device's development ever since.

Dr. Heist thought that Alan's fall risk made him a good candidate for the Watchman. The device is implanted during a short, minimally invasive procedure that doesn't put much stress on the body.

"If you have AFib, an elevated risk of stroke, and some rationale for not taking a blood thinner long term, then the Watchman is probably going to make sense," Dr. Heist explained. "Alan is in his mid-80s, which is a pretty common age for it, and we've even used it in people up to their late 90s."

Alan was on board with Dr. Heist's recommendation and returned to Mass General for the procedure three months later.

Going home the same day with Home Hospital

Alan's procedure took place early one morning. It went smoothly, and he woke up around 9:45 a.m. feeling surprisingly good. "I had no aftereffects—no grogginess, no nausea, no pain," he said. "I was very pleased."

Now the question was, how long would he need to stay at Mass General? A week earlier, a Mass General Brigham Home Hospital representative had said that if the procedure went well, Home Hospital would be a possibility.

"I'd never heard of Home Hospital," Alan recalled. "But the more I talked about it with my care team, the more confident I became. They didn't have to twist my arm to get me to agree to it."

After examining him early that afternoon, Dr. Heist cleared Alan for care through Home Hospital.

"Patients want to be home, where they rest better and are more comfortable," Dr. Heist said. "With Mass General Brigham's Home Hospital, when we can get them back home sooner, it's all the better. As a secondary benefit, it opens up beds for other patients who need to be hospitalized."

By mid-afternoon, a Mass General Brigham van was taking Alan to his home in Newton, Massachusetts. Susan was there to greet him. So was a Home Hospital paramedic, who had already set up all the equipment needed to monitor Alan's heart.

"Everything worked like a fine Swiss watch," Alan marveled. "They made it very easy through Home Hospital."

For the rest of the day and into the next morning, the Home Hospital team monitored Alan remotely. He and Susan had several phone numbers they could call if anything went wrong. As expected, there were no problems.

The next morning, a Home Hospital nurse stopped by. Over the course of an hour, she checked Alan's health, including performing an electrocardiogram (a test to check the heartbeat) and a blood test. Satisfied with the results, she discharged Alan from Home Hospital in consultation with the Home Hospital provider.

Looking forward to a future without blood thinners

Alan took two weeks off before resuming his usual athletic activities. Today, less than a month since the procedure, he feels great. He is scheduled to stop taking blood thinners six weeks post-procedure. After that, he will only need to take one drug to prevent blood clots for six months along with aspirin long term.

Alan, who will continue to see Dr. Singh for his heart care, couldn't be happier with his outcome—or his care through Mass General Brigham.

"The people I met at Mass General during my procedure were terrific, as were the people I met through Home Hospital," he said. "Everyone really delivered."

Learn about the Heart and Vascular Institute
Explore Home Hospital

What to Expect as a Home Hospital Patient

Watch this video to learn how Mass General Brigham Home Hospital brings expert medical care, advanced monitoring, and personalized treatment right to your doorstep.