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 adjustmentTCT-306 Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion
Vora A, Pereira L, Du C, Huang C, Friedman D, Wang Y, Zimmerman S, Faridi K, Higgins A, Kapadia S, Curtis J, Freeman J. TCT-306 Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion. Journal Of The American College Of Cardiology 2024, 84: b71. DOI: 10.1016/j.jacc.2024.09.360.Peer-Reviewed Original ResearchAnticoagulation 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 postapproval 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 postapproval study. Heart Rhythm 2024, 21: 2126-2135. 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 studySafety 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 ResearchPercutaneous left atrial appendage occlusionLeft atrial appendage occlusionAtrial appendage occlusionAppendage occlusionPatientsRegistryFrailtyOcclusionFrailty 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 ratesEchocardiographyCE-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 ResearchLeft atrial appendage occlusionAtrial appendage occlusionCatheter ablation proceduresWatchman FLXAppendage occlusionAblation proceduresResearch 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
Abnormal left atrial body stiffness is predicted by appendage size: impact of appendage occlusion on left atrial mechanics assessed by pressure-volume analysis
Bregasi A, Freeman JV, Curtis JP, Akar JG, Ortiz-Leon XA, Maia JH, Higgins AY, Matthews RV, Sinusas AJ, McNamara RL, Sugeng L, Lin BA. Abnormal left atrial body stiffness is predicted by appendage size: impact of appendage occlusion on left atrial mechanics assessed by pressure-volume analysis. AJP Heart And Circulatory Physiology 2022, 323: h559-h568. PMID: 35960632, PMCID: PMC9576173, DOI: 10.1152/ajpheart.00083.2022.Peer-Reviewed Original ResearchConceptsLeft atrial appendage occlusionLA stiffnessAppendage occlusionLA appendageLA mechanicsTransesophageal echocardiographyPressure-volume analysisPercutaneous left atrial appendage occlusionAdverse atrial remodelingAtrial appendage occlusionLeft atrial appendageLA volume measurementsAtrial cardiomyopathyBaseline characteristicsLA complianceAtrial remodelingClinical outcomesAtrial appendageAtrial mechanicsCardiac performancePathophysiological roleBaseline parametersMagnitude of increaseAppendage sizeOcclusionIndications 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 procedureAntithrombotic 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 strategies