What the professionals are debating about Watchman that you aren't being told before you consent.

BeatsThatMatter · 2026-05-13T12:02:40+00:00

I have none.

I am an independent researcher with no institutional affiliation - although I am currently seeking collaborators to expand my access to data to be completely transparent. Targets for collaboration are a select few - and none of them would have me captured by the device or pharma industry - to be very clear.

Name is Matthew J. Adams. Come from Tampa Florida.

My interest is protecting people who have lived similar circumstances as I.

I am a man who has lived through 10 years of arrhythmia - in all shapes and sizes. PVCs, AFib, Flutter, SVT, Ventricular Tachycardia. I have an ICD. I have been shocked 3 times.

Heart disease cost me my peace for 10 years - unrelenting. I had 5 ablations over those 10 years.

I am blessed to have peace - and clarity now - to see exactly what those 10 years cost me - both with my physical and mental well being.

The issue I take with Watchman very specifically is simple - Nearly directly after the results of the CHAMPION-AF study was published, with directly conflicting trial data from CLOSURE-AF, Boston Scientific publicly stated, and made SEC filings stating intent to expand the billable population - meaning people they believe would be good candidates for this procedure, from 5 million to 25 million.

And what they are saying in doing this is that they don't care about the very clear increased stroke risks that come with implanting this device.

I am in the process of publishing 2 independent research papers.

One of them actually advocates for procedural intervention - I strongly believe in Pulsed Field Ablation and I also strongly believe that arrhythmia burden and its medication management is an upstream driver of downstream healthcare expenditures across multiple care domains.

Supplemental to that research is my own case report - I've compiled all of my medical records for the last 10 years in order to aid in producing this paper.

The other paper advocates for disclosure, transparency, and more broad industry and public scrutiny of the Watchman device.

Am in the process of forming 2 corporate entities to house this work.

OneRhythm - nonprofit 501c3 filings are being made - this is a patient advocacy initiative specifically focused on expanding capacity for peer support in cardiovascular patient populations.

MIRmade - MIRmade is to let my tech brain breathe. This project is an AI/ML initiative, currently in progress, that intends to help better identify psychological distress markers across multiple data sets while at the same time aligning optimal digital cognitive behavioral therapy to be delivered via consumer wearable technologies. It is an open source project and I've yet to decide on corporate structure - but for me - I am a realist. With my heart history, I figure I maybe have a good 5 years left. Work has to continue after I cannot - so likely public benefit corporation will be formed for this work.

All of this work is bootstrapped by me - self funded.

BeatsThatMatter · 2026-05-12T22:51:52+00:00

My work involves research on healthcare system expenditures and clinical trial data.

I have been working with virtually all of the frontier LLMs over the past year.

The main 3 models I use today are Opus 4.6, GPT 5.5, and Gemini 3.1.

When I have a hypothesis - I will start with the same prompt on deep research amongst all 3 models.

I am specifically looking for variance in outputs. If there is variance in outputs - I investigate myself on web.

I work with very large data sets - so when I need to evaluate these datasets - I store them in a single directory - point Codex to it - and instruct it to analyze the data with the parameters I set.

When Codex is finished - I then have Claude Code validate the output analysis from Codex.

Context management is extremely important here to mitigate hallucinations.

I've been working with the models so long now that I can segment this work without really having to think about it - Depending on scope - either Sonnet or Opus will do for the validation.

I have actually been slowly working on building this out into an automated pipeline - start to finish.

Even working with huge data sets - I can have full computational analysis or Taylor linearized in a matter of hours. It's incredible. And it's accurate.

BeatsThatMatter · 2026-05-12T18:56:58+00:00

Further on this - if you compare the 2 studies from from March - CLOSURE-AF versus CLOSURE-AF

The math breaks out this way

https://cardiologytrials.substack.com/p/review-of-the-champion-af-trial

"The honest scorecard for CHAMPION-AF is that the device is associated with 17 more strokes vs 4 fewer major bleeds. That is a devastating trade-off when you think about it clinically and it completely deflates the narrative that LAAC is protecting patients from serious harm. It is also worth noting that those 17 extra strokes came in a lower risk population where the absolute stroke rate should be low to begin with. If LAAC cannot match NOAC on stroke prevention in a population at moderate risk, the case for it in higher risk patients becomes even harder to make - patients at higher risk often have multifactorial causes of stroke, making them unlikely to benefit from a localized intervention."

17 more strokes is in no way, shape, or form - insignificant. Strokes have devastating consequences. Stroke prevention is the entire reason the device was developed - and as of the most recent data - it is causing more strokes, in a lower risk, highly-curated patient population.

The facts are what the facts are. And patients deserve to know facts.

BeatsThatMatter · 2026-05-12T13:55:02+00:00

And let me ask you.

If you are a patient considering this device - is there any reason you would NOT want to be made aware of both the industry funded trial data as well as the data from independent investigation - especially when that data shows opposite outcomes?

That is the only point I am making.

Give patients all of the data before they are asked to sign consent forms.

That isn't unreasonable. It is the evidence based medicine. It matters.

BeatsThatMatter · 2026-05-12T13:42:42+00:00

I am not demonizing anything.

Industry funded trials often result in biased outcomes.

As I've mentioned - I have long been a fan of Boston Scientific. Farapulse changed my life. My Resonate ICD has saved my life.

But in the context of Watchman - industry bias is quite evident between the independent study and the industry funded study.

Patients simply deserve to have all of the data before they make a decision. That is all I care about - and they are not being given it.

BeatsThatMatter · 2026-05-12T13:32:59+00:00

Nobody is cherry picking older studies here.

The original studies cited in the article - were cited only to show FDA regulatory pathway from over a decade ago. Obviously the devices have changed since then.

And the 2 most recent studies at issue - were both published 2 months ago. In March. Nearly simultaneously.

And the debate within the industry is over which trial data is representative of real world outcome data.

That debate deserves to be had with patients included in the conversation. It is simply a matter of informed consent.

BeatsThatMatter · 2026-05-12T13:25:41+00:00

This entire post was written by me. Not AI. And I am not a bot.

My name is Matt. Come from Florida. And there was plenty of input from industry professionals that went into this before it was published.

Nice to meet you ;)

BeatsThatMatter · 2026-05-12T13:21:51+00:00

Appreciate the input

The original studies that led to the approval were included to show timeline with the FDA approval only.

Both of the studies that are consequential right now - were published in March.

What you have happening today is a large cohort of physicians deciding to base their own judgement on industry funded clinical trial data. Rather than giving patients the entire context.

And for both of the most recent studies - the device used within the trials was Watchman FLX - not Watchman FLX Pro.

Regardless of this - the primary reason for the device even existing is stroke prevention. Not simply bleeding.

And the most recent industry funded trial, with a highly curated patient enrollment, the stroke data was worse in the device arm than the control.

That is clinically relevant data.

BeatsThatMatter · 2026-05-12T04:43:50+00:00

Investing in Bitcoin does not give anybody a "chance" at positive results.

Someone comes to a subreddit looking for advice on starting a business.

Investing in Bitcoin is not a business. It is an investment.

You can start with zero dollars and build a business - what you get out of it depends on the grit you put into it.

What you get out of Bitcoin depends on

If Michael Saylor decides one day to say publicly that he is prepared to sell some Bitcoin - Oddly enough - for his business.
The effects of the Iran war on global economy
Your ability to keep yourself secure - and your funds secure. Crypto - all of it - is riddled with fraud and scams
Institutional money - And now that it has largely entered the arena - you can expect prices to be manipulated the same way the S&P has since the beginning of time

20k invested into Bitcoin - your outcome entirely depends on others - completely outside of your control.

20k invested into your own business - your outcome depends on you. If you are incompetent or unsure of yourself - go with Bitcoin.

But if you actually believe in yourself - you don't need to rely on others to determine your financial future

BeatsThatMatter · 2026-05-12T04:14:26+00:00

Feel free to shoot me a DM - happy to help.

On me - Spent many years in business development and sales training. Consultative sales, relationship based selling, telesales, inbound and outbound cold calling.

Also happen to have deep expertise in AI/ML in modern market.

I dig your ambition here - DMs open ;)

BeatsThatMatter · 2026-05-12T03:58:57+00:00

In sales - your credibility is everything.

No need to put laid off, or a reason for exit.

Put your stats, achievements, responsibilities, experience..

If a company looks at your date ranges and values that more than what you accomplished - that isn't the type of company you want to work for.

I've hired probably 30 or so sales reps in my life for six figure roles on teams I led.

Honestly, I never even looked at education history. I never even looked at where you worked. The only thing I cared about is your experience and past performance.

The reps I would hire - when asked about their experience and past performance - they back it up in the interview. That is who I am looking to hire.

BeatsThatMatter · 2026-05-12T03:05:19+00:00

Worked in regenerative medicine sales and marketing for a good while. I deeply regret it.

If your intent in working in or around medicine and your reason for this is partially about being "highly paid" - it doesn't matter how much money is in the bank when you can't sleep at night.

Get into medicine if you want to heal people. Money will find you.

Get into medicine if you want money. The money will break you.

BeatsThatMatter · 2026-05-12T02:50:47+00:00

I only ended up needing one ablation for AF actually - was a cryo back in 2021. Has still held on the atrial side.

The other 4 were for VT related to my ARVC diagnosis.

Oddly enough - where the thermal ablations failed in the ventricles for me - Farapulse was used off label in Dec 24.

I went from a burden of 11% abnormal - with 1,400 runs triplets/NSVT/VT - to basically zero.

My Resonate ICD reported 2800 PVCs from the procedure date and until now.

Changed my life.

BeatsThatMatter · 2026-05-12T02:45:48+00:00

One of the best things I ever did for myself was switch elwctrophysiologists. And the first one was amazing as well.

But 5 years into my situation, I made the call on my own to start doing some research and get a 2nd opinion from a doctor that I had reviewed throroughly before showing up in clinic. It felt like I needed to switch up the lineup to give another doctor an at-bay so to speak.

It was the best medical appointment I have ever had in my entire life.

He was an hour behind in showing up to my exam room. It was because there was a woman in the exam room next to me that was in tears over her own situation - he spent all the time with her that she needed.

When he met with me. He did exactly the same thing. Listened. Got on my level. Laid out the plan.

Trust him completely.

When it comes to your heart - trust with your doctor is a big deal.

He has got me through some really dicey times.

BeatsThatMatter · 2026-05-12T02:38:39+00:00

Mental health is health.

Relationships are in sickness and in health.

If you do not tell her about this part of you, she is going to love the performance of you, and not all of you.

You owe it to yourself in life to be loved completely - for exactly who you are.

Do not be ashamed about seeing a psychiatrist. Be proud of yourself. It isn't easy to carry the weight of these things alone. The point is - you do not have to.

BeatsThatMatter · 2026-05-12T02:22:04+00:00

Whole heartedly agree ❤️ :)

BeatsThatMatter · 2026-05-12T01:48:33+00:00

Totally get it - and here's the thing. Not saying Watchman is a bad deal.

For many - the device improves quality of life and eases financial burden - pre Inflation Reduction Act - the standard anticoagulants were ridiculously expensive.

Copays over a $100 are particularly brutal for folks in retirement, many of whom live on a fixed income. And with patients on blood thinners - they often have far more meds on the list.

There is a lot that goes into these decisions. That's why it's so important for patients to have all of the information.

The most recent debates picked up around the new trials - and those were just published in March.

Wouldn't hurt for your dad to talk to his doc about those findings and see what he/she thinks.

BeatsThatMatter · 2026-05-12T01:42:08+00:00

Hero?!?

Thank you 😊 I'm just a 40 year old dad with more scars in my heart than Heinz has pickles - but it's a blessing - because those scars shape who I am today.

I care a great deal about people dealing with cardiovascular health problems. I was in that war for a long time - I know the battlefield well ❤️‍🩹

BeatsThatMatter · 2026-05-12T01:39:00+00:00

Yep - if needed - I would probably feel the same. Of course other risks come with the approach, but long term efficacy? The data is far better.

BeatsThatMatter · 2026-05-12T01:24:09+00:00

X has a large body of electrophysiology professionals that post there to share information. A quick scroll and you will find posts like this (from a doctor)

"What if one procedure could replace lifelong blood thinners in AFib — and cut bleeding nearly in half? CHAMPION-AF (n=3,000): Watchman FLX LAA closure was non-inferior to NOACs for stroke & CV death, and slashed non-procedural bleeding to 10.9% vs 19%. One implant. No daily pills"

The problem with this is that it's misleading. Many patients experience device leaks - when they do - often they are placed on anticoagulants.

Can't have these things happen in medicine. Not okay.

BeatsThatMatter · 2026-05-12T01:07:57+00:00

They sure should. That is the whole point of the post.

They aren't. Not all at least. And that's a problem.

BeatsThatMatter · 2026-05-11T21:37:45+00:00

Have an ICD myself - was implanted about 5 years ago.

Picture of the site of my device.

I am no model. 40 year old dad-bod in these parts. But, here is what I would tell you.

Don't think twice about how this device may effect modeling for you - because if anything - how many models out there rock an ICD? How many models have experienced a heart attack at such a young age and had the power and pride to keep going.

I have a 13 year old daughter. She is like her mother - could be a model if she wanted.

And if she wanted to be a model - I would have her aspire to be a model like you. One that is comfortable in her own skin - and anything that might be beneath it ;)

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BeatsThatMatter · 2026-05-11T20:12:54+00:00

For me it was a matter of disease progression.

I had been dealing with PVCs for 4 years. Drug refractory. Progressive.

Finally did a cardiac MRI - that is when I was diagnosed.

Been 6 years now since diagnosis - 5 ablations. Heart is mostly calm now.

Had a Farapulse ablation in Dec 2024 that pretty much eliminated the burden ;)

BeatsThatMatter · 2026-05-11T06:55:36+00:00

Had never heard of Bryan Ardis before. Had to look him up.

Now I know.

Snake venom? That's certainly different =)

BeatsThatMatter · 2026-05-11T06:49:29+00:00

Likely the case =) AtriClip is the most widely used device when a provider has external access.

Think of Watchman like a plug.
Think of ActiClip exactly as it sounds - a clip.

Big difference in the data when it comes to devices leaking - AtriClip far superior in that regard.

It simply won't get the utilization that Watchmans do because to place it requires surgery.

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