2024
Racial and Ethnic Disparities in the Use and Outcomes With WATCHMAN FLX: A SURPASS Analysis of the NCDR Left Atrial Appendage Occlusion Registry.
Alli O, Garg J, Boursiquot B, Kapadia S, Yeh R, Price M, Piccini J, Nair D, Hsu J, Gibson D, Allocco D, Christen T, Sutton B, Freeman J. Racial and Ethnic Disparities in the Use and Outcomes With WATCHMAN FLX: A SURPASS Analysis of the NCDR Left Atrial Appendage Occlusion Registry. Journal Of The American Heart Association 2024, e036406. PMID: 39575715, DOI: 10.1161/jaha.124.036406.Peer-Reviewed Original ResearchLeft atrial appendage occlusionWatchman FLX implantationBlack patientsHispanic patientsOral anticoagulantsProcedural successRates of 1-year deathWhite patientsAlternative to oral anticoagulationRate of procedural successEthnic minority groupsEthnic minority individualsRate of deathSignificant bleedingWatchman FLXMinority individualsAppendage occlusionAntiplatelet therapyBaseline characteristicsAtrial fibrillationAnalyses assessed differencesMinority groupsPatientsStroke preventionBleedingAssociation of Chronic Kidney Disease and Kidney Failure with Replacement Therapy with Procedural and Long-Term Outcomes after First Generation Watchman Device: Insights from the NCDR LAAO Registry
Munir M, Tan Z, Pun P, Wang Y, Tandar A, Darden D, Hsu J, Friedman D, Curtis J, Freeman J. Association of Chronic Kidney Disease and Kidney Failure with Replacement Therapy with Procedural and Long-Term Outcomes after First Generation Watchman Device: Insights from the NCDR LAAO Registry. Heart Rhythm 2024 PMID: 39515495, DOI: 10.1016/j.hrthm.2024.10.071.Peer-Reviewed Original ResearchChronic kidney diseaseLong-term outcomesLeft atrial appendage occlusionAssociation of chronic kidney diseaseNational Cardiovascular Data Registry LAAO RegistryReplacement therapyAdverse eventsAtrial fibrillationKidney diseaseKidney failureAssociated with higher ratesIn-hospital deathRisk of strokeRate of strokeBilling claimsAF patientsProcedural complicationsAppendage occlusionWatchman deviceMultivariate analysisKFRTHigh riskPatientsRegistryComplicationsAssociation of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion
Vora A, Pereira L, Du C, Tan Z, Huang C, Friedman D, Wang Y, Faridi K, Lakkireddy D, Zimmerman S, Higgins A, Kapadia S, Curtis J, Freeman J. Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion. JACC Cardiovascular Interventions 2024 PMID: 39474982, DOI: 10.1016/j.jcin.2024.10.020.Peer-Reviewed Original ResearchPhysician certificationAppendage occlusionAdverse eventsPercutaneous left atrial appendage occlusionLong-term oral anticoagulationDischarged patientsMultivariate Cox proportional hazards regression analysisRate of procedural complicationsLeft atrial appendage occlusionCox proportional hazards regression analysisProportional hazards regression analysisRisk of adverse eventsHazards regression analysisIn-hospital deathOral anticoagulantsWatchman FLXNo significant differenceLAAO devicesProcedural complicationsStratify patientsIntracardiac echocardiographyAtrial fibrillationEligible patientsIdentified patientsMultivariable adjustmentProcedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry
Kattel S, Tan Z, Lin Z, Mszar R, Sanders P, Zeitler E, Zei P, Bunch T, Mansour M, Akar J, Curtis J, Friedman D, Freeman J. Procedural Volume and Outcomes with Atrial Fibrillation Ablation: A Report from the NCDR AFib Ablation Registry. Heart Rhythm 2024 PMID: 38960302, DOI: 10.1016/j.hrthm.2024.06.056.Peer-Reviewed Original ResearchProcedure volumeProcedural successVolume outcome relationshipAblation RegistryPhysician procedure volumeAtrial fibrillationPhysician volumeFirst-time AF ablationU.S. hospitalsNational cohortLikelihood of procedural successHospital volumeAcute procedural successAtrial fibrillation ablationPhysiciansHospitalAF ablationCompare outcomesNCDRRegistryAdverse eventsOutcome relationshipAnnual volumeMAE rateOutcomes
2023
DAPT 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 burdenSCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure
Saw J, Holmes D, Cavalcante J, Freeman J, Goldsweig A, Kavinsky C, Moussa I, Munger T, Price M, Reisman M, Sherwood M, Turi Z, Wang D, Whisenant B. SCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 100577. PMID: 39130704, PMCID: PMC11307869, DOI: 10.1016/j.jscai.2022.100577.Peer-Reviewed Original ResearchAtrial appendage closureAppendage closureConsensus statementTranscatheter Left Atrial Appendage ClosureLeft atrial appendage closureImportant clinical trialsExpert consensus statementLeft atrial appendageCardiovascular Computed TomographyDrug Administration approvalEvidence-based best practicesThromboembolic riskWatchman deviceLAAC procedureAtrial fibrillationAtrial appendageAdministration approvalClinical trialsCardiovascular AngiographyAmerican CollegeComputed tomographyClinical developmentClinical practiceEndovascular devicesResearch 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 devicesResidual stroke risk despite oral anticoagulation in patients with atrial fibrillation
Carlisle M, Shrader P, Fudim M, Pieper K, Blanco R, Fonarow G, Naccarelli G, Gersh B, Reiffel J, Kowey P, Steinberg B, Freeman J, Ezekowitz M, Singer D, Allen L, Chan P, Pokorney S, Peterson E, Piccini J, Patients and Investigators O. Residual stroke risk despite oral anticoagulation in patients with atrial fibrillation. Heart Rhythm O2 2022, 3: 621-628. PMID: 36589908, PMCID: PMC9795305, DOI: 10.1016/j.hroo.2022.09.018.Peer-Reviewed Original ResearchTransient ischemic attackPermanent atrial fibrillationOral anticoagulationAtrial fibrillationVASc scoreIschemic attackThromboembolic eventsFemale sexPrevious stroke/transient ischemic attackStroke/transient ischemic attackTransient ischemic attack eventsCox proportional hazard modelingResidual riskResidual stroke riskBetter Informed TreatmentRisk of thromboembolismProportional hazard modelingSystemic embolismPrevious strokeStroke riskOutcomes RegistryMean ageRisk markersOutcome eventsThromboembolismSex-based differences in atrial fibrillation ablation adverse events
Mszar R, Friedman D, Ong E, Du C, Wang Y, Zeitler E, Cunningham S, Akar J, Curtis J, Freeman J. Sex-based differences in atrial fibrillation ablation adverse events. Heart 2022, 109: 595-605. PMID: 36104219, DOI: 10.1136/heartjnl-2022-321192.Peer-Reviewed Original ResearchConceptsAcute pulmonary vein isolationAdverse eventsPulmonary vein isolationAtrial fibrillationHigh riskSex-based differencesVein isolationCatheter ablationFemale sexLarge prospective registryHospital adverse eventsMajor adverse eventsObservational cohort studyPhrenic nerve damageAF ablation proceduresQuality of lifeAblation RegistryMore comorbiditiesProspective registryAF ablationCohort studyPericardial effusionNerve damagePatient sexVascular injuryLeft 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 occlusionPO-634-05 RATES AND PREDICTORS OF HOSPITAL AND EMERGENCY DEPARTMENT CARE AFTER CATHETER ABLATION OF ATRIAL FIBRILLATION
Friedman D, Freeman J, Wong C, Febre J, Khanna R, Piccini J. PO-634-05 RATES AND PREDICTORS OF HOSPITAL AND EMERGENCY DEPARTMENT CARE AFTER CATHETER ABLATION OF ATRIAL FIBRILLATION. Heart Rhythm 2022, 19: s181. DOI: 10.1016/j.hrthm.2022.03.929.Peer-Reviewed Original ResearchAntithrombotic Therapy After Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation
Freeman JV, Higgins AY, Wang Y, Du C, Friedman DJ, Daimee UA, Minges KE, Pereira L, Goldsweig AM, Price MJ, Reddy VY, Gibson D, Doshi SK, Varosy PD, Masoudi FA, Curtis JP. Antithrombotic Therapy After Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation. Journal Of The American College Of Cardiology 2022, 79: 1785-1798. PMID: 35512858, PMCID: PMC9097170, DOI: 10.1016/j.jacc.2022.02.047.Peer-Reviewed Original ResearchConceptsLeft atrial appendage occlusionAdverse eventsPivotal trialsWatchman deviceTreatment protocolAntithrombotic strategiesAppendage occlusionLower riskFrailty regressionPercutaneous left atrial appendage occlusionNational Cardiovascular Data RegistryContemporary U.S. practiceDual antiplatelet therapyAtrial appendage occlusionConcomitant aspirinPostprocedure careAdjusted riskAntiplatelet therapyAntithrombotic medicationAntithrombotic therapyAtrial fibrillationAdverse outcomesTrial protocolAntithrombotic agentsMedication strategiesLongitudinal Outcomes of Subcutaneous or Transvenous Implantable Cardioverter-Defibrillators in Older Patients
Friedman DJ, Qin L, Parzynski C, Heist EK, Russo AM, Ranasinghe I, Zeitler EP, Minges KE, Akar JG, Freeman JV, Curtis JP, Al-Khatib SM. Longitudinal Outcomes of Subcutaneous or Transvenous Implantable Cardioverter-Defibrillators in Older Patients. Journal Of The American College Of Cardiology 2022, 79: 1050-1059. PMID: 35300816, DOI: 10.1016/j.jacc.2021.12.033.Peer-Reviewed Original ResearchConceptsOlder patientsCause readmissionS-ICDNational Cardiovascular Data Registry ICD RegistryDevice removalTransvenous implantable cardioverter defibrillatorTV-ICD patientsRisk of deathS-ICD patientsService Medicare beneficiariesAnderson-Gill modelsImplantable cardioverter defibrillatorRepresentative national cohortCompeting-risks modelTV-ICDCardiovascular readmissionCause mortalityICD implantationYounger patientsICD RegistryNonfatal outcomesTransvenous ICDAtrial fibrillationNational cohortCardioverter defibrillatorChanges in left atrial appendage orifice following percutaneous left atrial appendage closure using three-dimensional echocardiography
Ortiz-Leon XA, Posada-Martinez EL, Bregasi A, Chen W, Crandall I, Pereira J, Faridi KF, Akar JG, Lin BA, McNamara RL, Freeman JV, Curtis J, Arias-Godinez JA, Sugeng L. Changes in left atrial appendage orifice following percutaneous left atrial appendage closure using three-dimensional echocardiography. The International Journal Of Cardiovascular Imaging 2022, 38: 1361-1369. PMID: 35064846, DOI: 10.1007/s10554-022-02525-y.Peer-Reviewed Original ResearchLAA occlusionWatchman deviceLAA orificeD velocityPercutaneous left atrial appendage closureLeft atrial appendage closureEccentricity indexLAA orifice diameterAtrial appendage closureAtrial appendage occlusionPercutaneous LAA occlusionPeak SMaximum diameterAtrial appendage orificeShort-axis viewThree-dimensional echocardiographyLong-term contraindicationsAppendage closureAppendage occlusionAtrial fibrillationTransesophageal echocardiography imagesAxis viewPatientsOcclusionSignificant differences
2021
Heart Watch Study: protocol for a pragmatic randomised controlled trial
Dhruva SS, Shah ND, Vemulapalli S, Deshmukh A, Beatty AL, Gamble GM, Freeman JV, Hummel JP, Piccini JP, Akar JG, Ervin K, Arges KL, Emanuel L, Noseworthy PA, Hu T, Bartlett V, Ross JS. Heart Watch Study: protocol for a pragmatic randomised controlled trial. BMJ Open 2021, 11: e054550. PMID: 35234659, PMCID: PMC8719216, DOI: 10.1136/bmjopen-2021-054550.Peer-Reviewed Original ResearchConceptsHealthcare utilisationSecondary outcomesAtrial fibrillationAtrial flutterDuke University Health SystemRoutine clinical care settingsAtrial Fibrillation EffectLife global scoresTime of cardioversionAdditional secondary outcomesPopulation of patientsPatient-reported outcomesClinical care settingsUniversity Health SystemQuality of lifeInstitutional review boardMulticentre pragmaticPeer-reviewed journalsPrimary outcomePatients' qualityTrial protocolClinical trialsMayo ClinicECG featuresCare settingsChange in hospitalization rates following transcatheter left atrial appendage occlusion
Mohammed M, Kattel S, Ahsan I, Samdani AJ, Chand S, Rai D, Bandyopadhyay D, Ranka S, Noheria A, Gupta SK, Sheldon SH, Rao M, Aronow WS, Freeman JV, Reddy M. Change in hospitalization rates following transcatheter left atrial appendage occlusion. Archives Of Medical Science - Atherosclerotic Diseases 2021, 6: e191-e195. PMID: 36161215, PMCID: PMC9487831, DOI: 10.5114/amsad.2021.111405.Peer-Reviewed Original ResearchAtrial appendage occlusionOral anticoagulantsAtrial fibrillationAppendage occlusionHospitalization ratesLong-term oral anticoagulantsNon-valvular atrial fibrillationDiagnosis of AFNationwide Readmissions DatabaseCause admissionsHospital stayIndex procedureMore admissionsHigh riskPatientsClinical practiceAverage preAdmissionMortality informationLAAOSignificant decreaseContraindicationsIncidenceMonthsOcclusionSex Differences in Procedural Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion
Darden D, Duong T, Du C, Munir MB, Han FT, Reeves R, Saw J, Zeitler EP, Al-Khatib SM, Russo AM, Minges KE, Curtis JP, Freeman JV, Hsu JC. Sex Differences in Procedural Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion. JAMA Cardiology 2021, 6: 1275-1284. PMID: 34379072, PMCID: PMC8358791, DOI: 10.1001/jamacardio.2021.3021.Peer-Reviewed Original ResearchConceptsHospital adverse eventsMajor adverse eventsAdverse eventsAtrial appendage occlusionMajor bleedingPericardial effusionAppendage occlusionAtrial fibrillationSex differencesCongestive heart failureCoronary artery diseaseAdjusted logistic regression analysisParoxysmal atrial fibrillationLogistic regression analysisMultivariable adjusted logistic regression analysesPrior strokeUncontrolled hypertensionHospital outcomesHospital stayMultivariable adjustmentProlonged hospitalBaseline characteristicsCohort studySelect patientsArtery diseaseNational Trends in the Burden of Atrial Fibrillation During Hospital Admissions for Heart Failure
Reinhardt SW, Chouairi F, Miller PE, Clark KAA, Kay B, Fuery M, Guha A, Freeman JV, Ahmad T, Desai NR, Friedman DJ. National Trends in the Burden of Atrial Fibrillation During Hospital Admissions for Heart Failure. Journal Of The American Heart Association 2021, 10: e019412. PMID: 34013736, PMCID: PMC8483517, DOI: 10.1161/jaha.120.019412.Peer-Reviewed Original ResearchConceptsReduced ejection fractionComorbid atrial fibrillationHeart failureAtrial fibrillationEjection fractionHospital mortalityHF hospitalizationBackground Heart failureConclusion Atrial fibrillationWhite individualsNational Inpatient SampleMedian hospital chargesMore comorbiditiesComorbid hypertensionHF admissionsHF outcomesPatient demographicsDiabetes mellitusHospital admissionHospital chargesInpatient SampleVascular diseaseHospitalizationPatientsMortality