2024
Anticoagulation Alone vs Anticoagulation Plus Aspirin or DAPT Following Left Atrial Appendage Occlusion
Reinhardt S, Gibson D, Hsu J, Kapadia S, Yeh R, Price M, Piccini J, Nair D, Christen T, Allocco D, Freeman J. Anticoagulation Alone vs Anticoagulation Plus Aspirin or DAPT Following Left Atrial Appendage Occlusion. Journal Of The American College Of Cardiology 2024, 84: 889-900. PMID: 39197978, DOI: 10.1016/j.jacc.2024.05.067.Peer-Reviewed Original ResearchConceptsLeft atrial appendage occlusionRate of adverse eventsAdverse eventsLAA closure deviceAppendage occlusionAntithrombotic strategiesP2Y<sub>12</sub> inhibitorsDays of follow-upMultivariable Cox proportional hazards regressionClosure deviceRisk of adverse eventsCox proportional hazards regressionWatchman FLX deviceDual antiplatelet therapyDevice-related thrombusProportional hazards regressionStroke/transient ischemic attackAntithrombotic regimensFLX deviceAntiplatelet therapyDOACsGroup patientsFollow-upMultivariate analysisHazards regressionProcedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion
Friedman D, Du C, Zimmerman S, Tan Z, Lin Z, Vemulapalli S, Kosinski A, Piccini J, Pereira L, Minges K, Faridi K, Masoudi F, Curtis J, Freeman J. Procedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion. Circulation Cardiovascular Interventions 2024, 17: e013466. PMID: 38889251, PMCID: PMC11189610, DOI: 10.1161/circinterventions.123.013466.Peer-Reviewed Original ResearchConceptsVolume-outcome relationshipLikelihood of procedural successLeft atrial appendage occlusionProcedural successProcedure volumeAppendage occlusionNational Cardiovascular Data Registry LAAO RegistryVolume quartilesLeft atrial appendage occlusion devicesThree-level hierarchical generalized linear modelsMinimum volume thresholdsWatchman FLX deviceProcedural success rateHierarchical generalized linear modelsAssociated with outcomePhysician volumeWATCHMAN procedureFLX deviceOcclusion deviceVolume thresholdCardiovascular proceduresPhysiciansHospitalNational analysisSuccess rateFEASIBILITY OF AMULET OCCLUDER IMPLANTATION AFTER FAILED LEFT ATRIAL APPENDAGE OCCLUSION ATTEMPT: INSIGHTS FROM THE EMERGE LAA POST-APPROVAL STUDY
Makkar A, Alkhouli M, Ellis C, Shah A, Coylewright M, Freeman J, Anderson J, Gage R, Lakkireddy D. FEASIBILITY OF AMULET OCCLUDER IMPLANTATION AFTER FAILED LEFT ATRIAL APPENDAGE OCCLUSION ATTEMPT: INSIGHTS FROM THE EMERGE LAA POST-APPROVAL STUDY. Heart Rhythm 2024 PMID: 38768843, DOI: 10.1016/j.hrthm.2024.05.004.Peer-Reviewed Original ResearchLeft atrial appendage occlusionAmulet occluderPost-approval studiesAdverse eventsImplant successOccluder implantationLow rate of adverse eventsRate of adverse eventsOutcomes of patientsSafety composite endpointImplantation attemptLAAO proceduresAppendage occlusionSafety endpointsPatient cohortComposite endpointFDA approvalPatientsHospital dischargeIntricate anatomyAnatomical scenariosOccluderImplantationEndpointLow ratePredicting Major Adverse Events in Patients Undergoing Transcatheter Left Atrial Appendage Occlusion
Faridi K, Ong E, Zimmerman S, Varosy P, Friedman D, Hsu J, Kusumoto F, Mortazavi B, Minges K, Pereira L, Lakkireddy D, Koutras C, Denton B, Mobayed J, Curtis J, Freeman J. Predicting Major Adverse Events in Patients Undergoing Transcatheter Left Atrial Appendage Occlusion. Circulation Arrhythmia And Electrophysiology 2024, 17: e012424. PMID: 38390713, PMCID: PMC11021146, DOI: 10.1161/circep.123.012424.Peer-Reviewed Original ResearchNational Cardiovascular Data RegistryLeft atrial appendage occlusionIn-hospital major adverse eventsMajor adverse eventsBedside risk scoreRisk scoreData RegistryIncreased fall riskAdverse eventsQuality improvement effortsWatchman FLXAppendage occlusionFall riskLeft atrial appendage occlusion procedureRegistry dataImprovement effortsRisk of in-hospital major adverse eventsPredicting major adverse eventsLogistic regressionAdverse event ratesModerate discriminationClinically relevant variablesFemale sexAtrial fibrillation terminationLAAO proceduresIn-hospital safety outcomes of left atrial appendage occlusion in octogenarians and nonagenarians
Ismayl M, Ahmed H, Goldsweig A, Freeman J, Alkhouli M. In-hospital safety outcomes of left atrial appendage occlusion in octogenarians and nonagenarians. EP Europace 2024, 26: euae055. PMID: 38391186, PMCID: PMC10927254, DOI: 10.1093/europace/euae055.Peer-Reviewed Original ResearchConceptsOutcomes of left atrial appendage occlusionLeft atrial appendage occlusionIn-hospital all-cause mortalityOdds of vascular complicationsLength of stayAll-cause mortalityYounger patientsAppendage occlusionComposite of in-hospital all-cause mortalityOdds of in-hospital all-cause mortalityVascular complicationsSafety outcomesAcute kidney injuryNational Inpatient Sample databaseRetrospective cohort studyInpatient Sample databaseYears of ageCardiac tamponadeBlood transfusionProcedural complicationsSafety profileKidney injuryLogistic regression modelsElderly patientsCohort studyFirst Experience With Amulet in the United States Early Insights From EMERGE LAA Postapproval Study
Alkhouli M, Freeman J, Ellis C, Shah A, Gada H, Coylewright M, Lo M, Makkar A, Agarwal H, Lakkireddy D. First Experience With Amulet in the United States Early Insights From EMERGE LAA Postapproval Study. JACC Cardiovascular Interventions 2024, 17: 422-434. PMID: 38310499, DOI: 10.1016/j.jcin.2023.11.027.Peer-Reviewed Original ResearchPericardial effusionAmulet occluderImplant successAdverse eventsIn-hospitalFood and Drug Administration approvalOpen cardiac surgeryMajor adverse eventsDrug Administration approvalComposite endpoint eventsFood and Drug AdministrationSafety composite endpointPatients in-hospitalImplantation attemptSystemic embolismCardiac surgeryAppendage occlusionOccluder implantationAdministration approvalComposite endpointDevice implantationEndpoint eventsPostapproval studiesEndovascular interventionLearning curve effectSafety and Efficacy of Combining Left Atrial Appendage Occlusion With Another Cardiac Procedure
Ismayl M, Ahmed H, Freeman J, Alkhouli M, Lakkireddy D, Goldsweig A. Safety and Efficacy of Combining Left Atrial Appendage Occlusion With Another Cardiac Procedure. JACC Cardiovascular Interventions 2024, 17: 262-273. PMID: 38267141, DOI: 10.1016/j.jcin.2023.10.017.Peer-Reviewed Original ResearchConceptsLeft atrial appendage occlusionLength of stayCardiac proceduresIn-hospital mortalityAppendage occlusionOutcomes of left atrial appendage occlusionConcomitant transcatheter aortic valve replacementVascular injuryTranscatheter aortic valve replacementConcomitant procedure groupConcomitant cardiac proceduresAortic valve replacementOdds of MACEAcute kidney injuryNational Inpatient Sample databaseRetrospective cohort studyRetrospective observational studyAdverse cardiovascular eventsInpatient Sample databaseOdds of strokeFlutter ablationValve replacementBlood transfusionClinical outcomesHeart block
2023
Correction: Frailty and associated outcomes in patients undergoing percutaneous left atrial appendage occlusion: findings from the NCDR LAAO registry
Darden D, Bilal Munir M, Zimmerman S, Eskander M, Pothineni N, Gopinathannair R, Kabra R, Lakkireddy D, Duong T, Han F, Freeman J, Hsu J. Correction: Frailty and associated outcomes in patients undergoing percutaneous left atrial appendage occlusion: findings from the NCDR LAAO registry. Journal Of Interventional Cardiac Electrophysiology 2023, 67: 637-637. PMID: 38019421, DOI: 10.1007/s10840-023-01704-8.Peer-Reviewed Original ResearchDAPT Is Comparable to OAC Following LAAC With WATCHMAN FLX A National Registry Analysis
Coylewright M, Holmes D, Kapadia S, Hsu J, Gibson D, Freeman J, Yeh R, Piccini J, Price M, Allocco D, Nair D. DAPT Is Comparable to OAC Following LAAC With WATCHMAN FLX A National Registry Analysis. JACC Cardiovascular Interventions 2023, 16: 2708-2718. PMID: 37943200, DOI: 10.1016/j.jcin.2023.08.013.Peer-Reviewed Original ResearchConceptsDual antiplatelet therapyDevice-related thrombusOral anticoagulationWatchman FLXStroke preventionLong-term oral anticoagulationComposite endpoint rateMedical therapy optionsNational registry analysisSimilar safety profilePropensity-matched analysisAtrial appendage occlusionAspirin patientsDAPT patientsMajor bleedingAntiplatelet therapyComposite endpointDrug regimensMedication regimensAppendage occlusionComorbid conditionsAtrial fibrillationRegistry analysisSafety profileMean ageFrailty and associated outcomes in patients undergoing percutaneous left atrial appendage occlusion: findings from the NCDR LAAO registry
Darden D, Bilal Munir M, Zimmerman S, Eskander M, Pothineni N, Gopinathannair R, Kabra R, Lakkireddy D, Duong T, Han F, Freeman J, Hsu J. Frailty and associated outcomes in patients undergoing percutaneous left atrial appendage occlusion: findings from the NCDR LAAO registry. Journal Of Interventional Cardiac Electrophysiology 2023, 67: 625-635. PMID: 37858000, DOI: 10.1007/s10840-023-01662-1.Peer-Reviewed Original ResearchAtrial appendage occlusionFrail patientsFrailty ScaleAdverse eventsAppendage occlusionHigh riskPercutaneous left atrial appendage occlusionLeft atrial appendage occlusionNon-frail patientsPre-frail patientsHospital adverse eventsModified Rankin ScaleHospital major complicationsRisk of complicationsBody mass indexRisk of fallsAdvanced age populationRankin ScaleMajor complicationsMass indexSignificant morbidityAtrial fibrillationMore disabilityWorse outcomesHigh burdenIntracardiac vs Transesophageal Echocardiography for Left Atrial Appendage Occlusion With Watchman FLX in the U.S.
Ferro E, Alkhouli M, Nair D, Kapadia S, Hsu J, Gibson D, Freeman J, Price M, Roy K, Allocco D, Yeh R, Piccini J. Intracardiac vs Transesophageal Echocardiography for Left Atrial Appendage Occlusion With Watchman FLX in the U.S. JACC Clinical Electrophysiology 2023, 9: 2587-2599. PMID: 37831030, DOI: 10.1016/j.jacep.2023.08.004.Peer-Reviewed Original ResearchConceptsAtrial appendage occlusionTransesophageal echocardiographyIntracardiac echocardiographyBaseline characteristicsAppendage occlusionLeft atrial appendage occlusionPericardial effusion rateSuccessful device implantationAdverse event ratesSimilar baseline characteristicsUnadjusted mortality ratesHigh rateICE patientsTEE patientsPericardial effusionPivotal trialsDevice implantationGeneral anesthesiaAdjusted comparisonsProcedural timeLAAO devicesDevice deliveryMortality rateEvent ratesEchocardiographyImpact of Preprocedure Imaging for Left Atrial Appendage Occlusion Insights From the NCDR LAAO Registry
Clarke J, Higgins A, Wang Y, Faridi K, Curtis J, Freeman J, Friedman D. Impact of Preprocedure Imaging for Left Atrial Appendage Occlusion Insights From the NCDR LAAO Registry. JACC Cardiovascular Interventions 2023, 16: 1317-1328. PMID: 37316143, DOI: 10.1016/j.jcin.2023.05.008.Peer-Reviewed Original ResearchConceptsDevice successImplantation successPreprocedure imagingProcedure successLAAO proceduresAbnormal renal functionAtrial appendage occlusionMultivariable logistic regressionOutcomes of interestMagnitude of benefitLAAO implantationPrior thromboembolismUncontrolled hypertensionRate of useRenal functionAppendage occlusionProcedural successUniversity HospitalLogistic regressionCMR useOverall rateCMRPatientsPreprocedureRegistryCE-452771-3 LEFT ATRIAL APPENDAGE OCCLUSION WITH THE WATCHMAN FLX AND CONCOMITANT CATHETER ABLATION PROCEDURES
Piccini J, Kapadia S, Yeh R, Price M, Hsu J, Freeman J, Gibson D, Christen T, Allocco D, Nair D. CE-452771-3 LEFT ATRIAL APPENDAGE OCCLUSION WITH THE WATCHMAN FLX AND CONCOMITANT CATHETER ABLATION PROCEDURES. Heart Rhythm 2023, 20: s35-s36. DOI: 10.1016/j.hrthm.2023.03.271.Peer-Reviewed Original ResearchCE-452771-4 OUTCOMES WITH DIFFERENT POSTPROCEDURAL ANTITHROMBOTIC THERAPY REGIMENS FOLLOWING LEFT ATRIAL APPENDAGE OCCLUSION
Freeman J, Hsu J, Kapadia S, Yeh R, Price M, Nair D, Christen T, Allocco D, Gibson D. CE-452771-4 OUTCOMES WITH DIFFERENT POSTPROCEDURAL ANTITHROMBOTIC THERAPY REGIMENS FOLLOWING LEFT ATRIAL APPENDAGE OCCLUSION. Heart Rhythm 2023, 20: s36-s37. DOI: 10.1016/j.hrthm.2023.03.272.Peer-Reviewed Original ResearchINTRACARDIAC VS TRANSESOPHAGEAL ECHOCARDIOGRAPHY USE FOR LEFT ATRIAL APPENDAGE OCCLUSION WITH WATCHMAN FLX: COMPARATIVE EFFECTIVENESS AND SAFETY AT 45 DAYS IN 40,738 PATIENTS FROM THE NCDR LAAO REGISTRY
Ferro E, Yeh R, Kapadia S, Hsu J, Gibson D, Freeman J, Price M, Alkhouli M, Roy K, Allocco D, Piccini J. INTRACARDIAC VS TRANSESOPHAGEAL ECHOCARDIOGRAPHY USE FOR LEFT ATRIAL APPENDAGE OCCLUSION WITH WATCHMAN FLX: COMPARATIVE EFFECTIVENESS AND SAFETY AT 45 DAYS IN 40,738 PATIENTS FROM THE NCDR LAAO REGISTRY. Journal Of The American College Of Cardiology 2023, 81: 90. DOI: 10.1016/s0735-1097(23)00534-x.Peer-Reviewed Original ResearchNOVEL 5-POINT FRAILTY SCALE IN PATIENTS UNDERGOING PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION: INSIGHTS FROM THE NCDR LAAO REGISTRY
Darden D, Zimmerman S, Munir M, Eskander M, Duong T, Pothineni N, Gopinathannair R, Lakkireddy D, Han F, Reeves R, Curtis J, Freeman J, Hsu J. NOVEL 5-POINT FRAILTY SCALE IN PATIENTS UNDERGOING PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION: INSIGHTS FROM THE NCDR LAAO REGISTRY. Journal Of The American College Of Cardiology 2023, 81: 45. DOI: 10.1016/s0735-1097(23)00489-8.Peer-Reviewed Original ResearchResearch Opportunities in Stroke Prevention for Atrial Fibrillation: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop
Go A, Al-Khatib S, Desvigne-Nickens P, Bansal N, Bushnell C, Fang M, Freeman J, Gage B, Hanke T, Hylek E, Lopes R, Noseworthy P, Reddy V, Singer D, Thomas K, Hills M, Turakhia M, Zieman S, Cooper L, Benjamin E. Research Opportunities in Stroke Prevention for Atrial Fibrillation: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop. Stroke 2023, 54: e75-e85. PMID: 36848427, PMCID: PMC9995163, DOI: 10.1161/strokeaha.121.038273.Peer-Reviewed Original ResearchConceptsAtrial fibrillationStroke preventionNational HeartRisk factorsPercutaneous left atrial appendage occlusionLeft atrial appendage occlusionStroke prevention therapyAF risk factorsStroke prevention strategiesRisk stratification toolAtrial appendage occlusionStrong risk factorIndividual patient levelOral anticoagulantsIschemic strokePrevention therapyAppendage occlusionStratification toolIntracranial hemorrhageLeading causeCardiovascular diseasePatient levelPrevention strategiesOptimal rolePrevention
2022
Device-Sizing and Associated Complications With Left Atrial Appendage Occlusion: Findings From the NCDR LAAO Registry
Sandhu A, Varosy P, Du C, Aleong R, Tumolo A, West J, Tzou W, Curtis J, Freeman J, Friedman D, Hess P. Device-Sizing and Associated Complications With Left Atrial Appendage Occlusion: Findings From the NCDR LAAO Registry. Circulation Cardiovascular Interventions 2022, 15: e012183. PMID: 36472194, DOI: 10.1161/circinterventions.122.012183.Peer-Reviewed Original ResearchConceptsAtrial appendage occlusionAppendage occlusionPericardial effusionLower oddsOversized deviceComposite adverse outcomeNonvalvular atrial fibrillationShort-term complicationsShort-term outcomesSignificant leakDevice embolismSelect patientsAdverse eventsWatchman deviceAssociated complicationsPeridevice leakAtrial fibrillationAdverse outcomesDevice embolizationHigh prevalenceDevice migrationManufacturer's recommendationsPatientsStudy periodUndersized devicesLeft Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation : A Decision Analysis.
Chew DS, Zhou K, Pokorney SD, Matchar DB, Vemulapalli S, Allen LA, Jackson KP, Samad Z, Patel MR, Freeman JV, Piccini JP. Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation : A Decision Analysis. Annals Of Internal Medicine 2022, 175: 1230-1239. PMID: 35969865, DOI: 10.7326/m21-4653.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsHigh bleeding riskLower stroke riskClinical effectiveness dataAtrial fibrillationBleeding riskStroke riskOral anticoagulantsIschemic strokeEffectiveness dataHAS-BLED scoreIndividual riskHigh stroke riskMajor bleeding riskNonvalvular atrial fibrillationPatient's individual riskPrimary end pointAtrial appendage occlusionBase-case analysisOral anticoagulationPrior strokeVASc scoreStroke preventionWatchman deviceAppendage occlusionIndications for Left Atrial Appendage Occlusion in the United States and Associated In-Hospital Outcomes: Results From the NCDR LAAO Registry
Daimee UA, Wang Y, Masoudi FA, Varosy PD, Friedman DJ, Du C, Koutras C, Reddy VY, Saw J, Price MJ, Kusumoto FM, Curtis JP, Freeman JV. Indications for Left Atrial Appendage Occlusion in the United States and Associated In-Hospital Outcomes: Results From the NCDR LAAO Registry. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008418. PMID: 35959677, PMCID: PMC9388561, DOI: 10.1161/circoutcomes.121.008418.Peer-Reviewed Original ResearchConceptsHospital adverse eventsHigh fall riskNational Cardiovascular Data RegistryProcedural indicationsAtrial appendage occlusionAdverse eventsWatchman implantationFall riskMajor bleedsThromboembolic riskAppendage occlusionData registryAbnormal renal/liver functionLeft atrial appendage occlusionIn-Hospital OutcomesMean patient ageTransient ischemic attackMajority of patientsInternational normalized ratioIschemic attackMean CHAOral anticoagulationPrior strokeVASc scoreWATCHMAN procedure