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 rate
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 ageInitial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures
Hsu J, Darden D, Du C, Marine J, Nichols S, Marcus G, Natale A, Noseworthy P, Selzman K, Varosy P, Masoudi F, Freeman J, Curtis J, Akar J, Kowey P. Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures. Journal Of The American College Of Cardiology 2023, 81: 867-878. PMID: 36858707, DOI: 10.1016/j.jacc.2022.11.060.Peer-Reviewed Original ResearchConceptsAtrial fibrillation ablation proceduresAblation RegistryHospital outcomesAblation proceduresSuccessful pulmonary vein isolationNational Cardiovascular Data RegistryOutcomes of patientsProspective cohort studyMajority of patientsPulmonary vein isolationEvidence-based guidelinesDifferent patient outcomesReal-world prevalenceProcedural admissionsHospital deathAF ablationCohort studyPericardial effusionVein isolationHeart failureLarge multicenterMajor complicationsCatheter ablationTreatment patternsPatient populationRates and predictors of hospital and emergency department care after catheter ablation of atrial fibrillation
Friedman D, Freeman J, Wong C, Febre J, Iglesias M, Khanna R, Piccini J. Rates and predictors of hospital and emergency department care after catheter ablation of atrial fibrillation. Journal Of Cardiovascular Electrophysiology 2023, 34: 823-830. PMID: 36738152, DOI: 10.1111/jce.15841.Peer-Reviewed Original ResearchConceptsPredictors of hospitalED careAF ablationED visitsPatient comorbiditiesSupraventricular tachycardiaUnscheduled careFemale sexCommon reasonDirect oral anticoagulationEmergency department evaluationNoncardiac chest painDays of dischargeRisk of rehospitalizationAtrial fibrillation ablationEmergency department careSame-day discharge programQuality improvement initiativesOptum Clinformatics databaseAdmission careMean CHAOral anticoagulationPostablation periodVASc scoreChest pain
2022
Sex-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 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 procedurePeriprocedural Pericardial Effusion Complicating Transcatheter Left Atrial Appendage Occlusion: A Report From the NCDR LAAO Registry
Price MJ, Valderrábano M, Zimmerman S, Friedman DJ, Kar S, Curtis JP, Masoudi FA, Freeman JV. Periprocedural Pericardial Effusion Complicating Transcatheter Left Atrial Appendage Occlusion: A Report From the NCDR LAAO Registry. Circulation Cardiovascular Interventions 2022, 15: e011718. PMID: 35369701, PMCID: PMC9132377, DOI: 10.1161/circinterventions.121.011718.Peer-Reviewed Original ResearchConceptsAtrial appendage occlusionComposite of deathPericardial effusionAppendage occlusionSystemic embolismOdds ratioEarly postdischarge mortalityDual antiplatelet therapyLow serum albuminMean patient ageAdverse event ratesParoxysmal atrial fibrillationRisk of deathRisk-benefit ratioHospital strokeMean CHAPostdischarge mortalityVASc scoreWATCHMAN procedureAntiplatelet therapyIndex hospitalizationAdverse eventsPatient agePrimary outcomeVentricular functionTo Occlude or Not to Occlude the Left Atrial Appendage in Women—Reply
Darden D, Freeman JV, Hsu JC. To Occlude or Not to Occlude the Left Atrial Appendage in Women—Reply. JAMA Cardiology 2022, 7: 464-465. PMID: 35171204, DOI: 10.1001/jamacardio.2021.5933.Peer-Reviewed Original ResearchLongitudinal 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 defibrillator
2021
Sex 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 diseaseCannabis use disorder among atrial fibrillation admissions, 2008–2018
Chouairi F, Miller PE, Guha A, Clarke J, Reinhardt SW, Ahmad T, Freeman JV, Desai NR, Friedman DJ. Cannabis use disorder among atrial fibrillation admissions, 2008–2018. Pacing And Clinical Electrophysiology 2021, 44: 1934-1938. PMID: 34506639, DOI: 10.1111/pace.14356.Peer-Reviewed Original ResearchConceptsAtrial fibrillation hospitalizationsAF hospitalizationsImpact of CUDNational Inpatient SampleProportion of admissionsDiseases diagnosis codesPrevalence of cannabisHistory of CUDHospital dischargeYounger patientsHigher proportionUnderserved patientsBlack raceDiagnosis codesInpatient SampleInternational ClassificationHospitalizationLegality of cannabisCannabis usePatientsAdmissionCodiagnosisLittle dataCUDCannabisNational 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 diseaseHospitalizationPatientsMortalityDosing of Direct Oral Anticoagulants in Patients with Moderate Chronic Kidney Disease in US Clinical Practice: Results from the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF II)
Jackson LR, Schrader P, Thomas L, Steinberg BA, Blanco R, Allen LA, Fonarow GC, Freeman JV, Gersh BJ, Kowey PR, Mahaffey KW, Naccarelli G, Reiffel J, Singer DE, Peterson ED, Piccini JP. Dosing of Direct Oral Anticoagulants in Patients with Moderate Chronic Kidney Disease in US Clinical Practice: Results from the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF II). American Journal Of Cardiovascular Drugs 2021, 21: 553-561. PMID: 33786798, DOI: 10.1007/s40256-021-00473-x.Peer-Reviewed Original ResearchConceptsModerate chronic kidney diseaseChronic kidney diseaseAtrial fibrillationRoutine clinical practiceClinical practiceInappropriate dosingOral anticoagulantsKidney diseaseConclusionIn routine clinical practiceMedian CHA2DS2VASc scoreComorbid medical conditionsDirect oral anticoagulantsUS clinical practiceBetter Informed TreatmentCockcroft-Gault formulaOne-thirdML/minCrCl 30CHA2DS2VASc scoreCreatinine clearanceRenal functionMedian ageDosage adjustmentOutcomes RegistryPrescribed dosesRelation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry)
Pareek M, Singh A, Vadlamani L, Eder M, Pacor J, Park J, Ghazizadeh Z, Heard A, Cruz-Solbes AS, Nikooie R, Gier C, Ahmed ZV, Freeman JV, Meadows J, Smolderen KGE, Lampert R, Velazquez EJ, Ahmad T, Desai NR. Relation of Cardiovascular Risk Factors to Mortality and Cardiovascular Events in Hospitalized Patients With Coronavirus Disease 2019 (from the Yale COVID-19 Cardiovascular Registry). The American Journal Of Cardiology 2021, 146: 99-106. PMID: 33539857, PMCID: PMC7849530, DOI: 10.1016/j.amjcard.2021.01.029.Peer-Reviewed Original ResearchConceptsCardiovascular risk factorsCoronavirus disease 2019Risk factorsHigher troponin TCardiovascular diseaseCardiovascular eventsHospitalized patientsLaboratory findingsMental statusDisease 2019Multivariable binary logistic regression analysisTroponin TMajor adverse cardiovascular eventsPre-existing cardiovascular diseaseHigher C-reactive proteinCOVID-19 positive patientsPredictors of MACEPrevious ventricular arrhythmiaUse of P2YAdverse cardiovascular eventsProspective cohort studyTertiary care centerC-reactive proteinBinary logistic regression analysisPoor prognostic marker
2020
Survival Following Implantable Cardioverter‐Defibrillator Implantation in Patients With Amyloid Cardiomyopathy
Higgins AY, Annapureddy AR, Wang Y, Minges KE, Lampert R, Rosenfeld LE, Jacoby DL, Curtis JP, Miller EJ, Freeman JV. Survival Following Implantable Cardioverter‐Defibrillator Implantation in Patients With Amyloid Cardiomyopathy. Journal Of The American Heart Association 2020, 9: e016038. PMID: 32867553, PMCID: PMC7726970, DOI: 10.1161/jaha.120.016038.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillator implantationCardioverter-defibrillator implantationNonischemic cardiomyopathyCardiac amyloidosisDiabetes mellitusCerebrovascular diseaseVentricular tachycardiaMultivariable Cox proportional hazards regression modelsCox proportional hazards regression modelProportional hazards regression modelsKaplan-Meier survival curvesCox proportional hazards modelPropensity-matched cohortOutcomes of patientsHazards regression modelsProportional hazards modelCause mortalityICD implantationRenal functionMultivariable analysisConclusions MortalityRisk factorsRegistry dataAmyloid cardiomyopathyHigh riskComparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation
Higgins AY, Bjerre J, Parzynski CS, Minges KE, Ahmad T, Desai NR, Enriquez A, Spatz ES, Friedman DJ, Curtis JP, Hlatky MA, Freeman JV. Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation. The American Journal Of Cardiology 2020, 133: 116-125. PMID: 32862971, DOI: 10.1016/j.amjcard.2020.07.035.Peer-Reviewed Original ResearchConceptsNon-ischemic cardiomyopathyImplantable cardioverter defibrillator implantationCardioverter-defibrillator implantationICM patientsIschemic cardiomyopathyNational Cardiovascular Data Registry ICD RegistryCox proportional hazards regression modelPrimary prevention ICD implantationLeft ventricular ejection fractionProportional hazards regression modelsPrimary prevention ICDsRetrospective cohort studyVentricular ejection fractionKaplan-Meier curvesHazards regression modelsRisk of mortalityComparison of mortalityMedian followCohort studyICD implantationEjection fractionHeart failureHospital readmissionICD RegistryPatient subgroupsEffect of Temporary Interruption of Warfarin Due to an Intervention on Downstream Time in Therapeutic Range in Patients With Atrial Fibrillation (from ORBIT AF)
Madhavan M, Holmes DN, Piccini JP, Freeman JV, Fonarow GC, Hylek EM, Kowey PR, Mahaffey KW, Pieper K, Peterson ED, Chan PS, Allen LA, Singer DE, Naccarelli GV, Reiffel JA, Steinberg BA, Gersh BJ, Investigators O. Effect of Temporary Interruption of Warfarin Due to an Intervention on Downstream Time in Therapeutic Range in Patients With Atrial Fibrillation (from ORBIT AF). The American Journal Of Cardiology 2020, 132: 66-71. PMID: 32826041, DOI: 10.1016/j.amjcard.2020.07.006.Peer-Reviewed Original ResearchConceptsInternational normalized ratioFirst therapeutic international normalized ratioTherapeutic international normalized ratioTherapeutic rangeAtrial fibrillationMajor bleedingTemporary interruptionAF patientsSubtherapeutic international normalized ratioBetter Informed TreatmentLow therapeutic rangeProportional hazards modelOutcomes RegistryNormalized ratioHigh incidenceLower riskHazards modelPatientsInformed TreatmentWarfarinSubsequent outcomesMonthsAnticoagulationRank testWeeksPatterns of oral anticoagulation use with cardioversion in clinical practice
Geurink K, Holmes D, Ezekowitz MD, Pieper K, Fonarow G, Kowey PR, Reiffel JA, Singer DE, Freeman J, Gersh BJ, Mahaffey KW, Hylek EM, Naccarelli G, Piccini JP, Peterson ED, Pokorney SD. Patterns of oral anticoagulation use with cardioversion in clinical practice. Heart 2020, 107: 642-649. PMID: 32591363, DOI: 10.1136/heartjnl-2019-316315.Peer-Reviewed Original ResearchConceptsStroke/transient ischemic attackVitamin K antagonistsNovel oral anticoagulantsTransient ischemic attackTransoesophageal echocardiogramAtrial fibrillationClinical practiceAtrial Fibrillation IIOral anticoagulation useTime of cardioversionBetter Informed TreatmentMonths of enrollmentIncidence of deathLow-risk procedureSimilar ratesAnticoagulation useIschemic attackMajor bleedingK antagonistsOral anticoagulantsClinical outcomesOutcomes RegistryCardiovascular hospitalisationAF diagnosisInclusion criteria