2024
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
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 ResearchProcedure 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 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 procedures
2023
NOVEL 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 Research
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 devicesAbnormal 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 strategiesPatient-Level Analysis of Watchman Left Atrial Appendage Occlusion in Practice Versus Clinical Trials
Friedman DJ, Du C, Wang Y, Agarwal V, Varosy PD, Masoudi FA, Holmes DR, Reddy VY, Price MJ, Curtis JP, Freeman JV. Patient-Level Analysis of Watchman Left Atrial Appendage Occlusion in Practice Versus Clinical Trials. JACC Cardiovascular Interventions 2022, 15: 950-961. PMID: 35512918, PMCID: PMC9370831, DOI: 10.1016/j.jcin.2022.02.029.Peer-Reviewed Original ResearchConceptsRegistry patientsHemorrhagic stroke riskIschemic strokeWarfarin patientsTrial patientsStroke riskLAAO patientsClinical practiceMore pericardial effusionsPeriprocedural ischemic strokePropensity-matched analysisAtrial appendage occlusionCox proportional hazardsPatient-level dataFine-Gray modelMore comorbiditiesPROTECT AFNoncardiovascular deathPericardial effusionHemorrhagic strokeAppendage occlusionDevice implantationTrial criteriaClinical trialsSimilar riskClinical Impact of Residual Leaks Following Left Atrial Appendage Occlusion Insights From the NCDR LAAO Registry
Alkhouli M, Du C, Killu A, Simard T, Noseworthy PA, Friedman PA, Curtis JP, Freeman JV, Holmes DR. Clinical Impact of Residual Leaks Following Left Atrial Appendage Occlusion Insights From the NCDR LAAO Registry. JACC Clinical Electrophysiology 2022, 8: 766-778. PMID: 35387751, PMCID: PMC9233062, DOI: 10.1016/j.jacep.2022.03.001.Peer-Reviewed Original ResearchConceptsPeri-device leakAdverse eventsResidual leakMajor adverse eventsProportion of patientsAdverse clinical eventsAtrial appendage occlusionAnticoagulant utilizationMajor bleedingSystemic embolizationAppendage occlusionClinical eventsClinical impactHigher oddsHigh incidencePatientsThromboembolicSignificant differencesRegistryLarge leaksLAAOLeakHigher proportionDaysAnticoagulationPeriprocedural 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 functionClinical Outcomes at 1 Year Following Transcatheter Left Atrial Appendage Occlusion in the United States
Price MJ, Slotwiner D, Du C, Freeman JV, Turi Z, Rammohan C, Kusumoto FM, Kavinsky C, Akar J, Varosy PD, Koutras C, Curtis JP, Masoudi FA. Clinical Outcomes at 1 Year Following Transcatheter Left Atrial Appendage Occlusion in the United States. JACC Cardiovascular Interventions 2022, 15: 741-750. PMID: 35393108, PMCID: PMC9116488, DOI: 10.1016/j.jcin.2022.02.009.Peer-Reviewed Original ResearchConceptsAtrial appendage occlusionIschemic strokeMajor bleedingClinical outcomesSystemic embolismAppendage occlusionMean HAS-BLED scoreHAS-BLED scoreKey secondary endpointKaplan-Meier methodCumulative event rateRate of mortalityMean CHAPrior strokeRelevant bleedingVASc scoreWATCHMAN procedurePrimary endpointSecondary endpointsThromboembolic eventsIntracranial bleedingBlood transfusionHemoglobin levelsHemorrhagic strokeKaplan-MeierPERIPROCEDURAL PERICARDIAL EFFUSION COMPLICATING TRANSCATHETER LEFT ATRIAL APPENDAGE OCCLUSION: A REPORT FROM THE NCDR LAAO REGISTRY
Price M, Valderrabano M, Zimmerman S, Friedman D, Curtis J, Masoudi F, Freeman J. PERIPROCEDURAL PERICARDIAL EFFUSION COMPLICATING TRANSCATHETER LEFT ATRIAL APPENDAGE OCCLUSION: A REPORT FROM THE NCDR LAAO REGISTRY. Journal Of The American College Of Cardiology 2022, 79: 581. DOI: 10.1016/s0735-1097(22)01572-8.Peer-Reviewed Original ResearchAtrial appendage occlusionAppendage occlusionChanges 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
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 diseaseB-PO03-155 OUTCOMES OF LEFT ATRIAL APPENDAGE OCCLUSION WITH WATCHMAN IN CONTEMPORARY CLINICAL PRACTICE COMPARED WITH CLINICAL TRIALS: A POOLED ANALYSIS OF PROTECT-AF, PREVAIL, AND THE NCDR LAAO REGISTRY
Friedman D, Du C, Agarwal Y, Varosy P, Masoudi F, Curtis J, Freeman J. B-PO03-155 OUTCOMES OF LEFT ATRIAL APPENDAGE OCCLUSION WITH WATCHMAN IN CONTEMPORARY CLINICAL PRACTICE COMPARED WITH CLINICAL TRIALS: A POOLED ANALYSIS OF PROTECT-AF, PREVAIL, AND THE NCDR LAAO REGISTRY. Heart Rhythm 2021, 18: s252. DOI: 10.1016/j.hrthm.2021.06.628.Peer-Reviewed Original Research
2020
The NCDR Left Atrial Appendage Occlusion Registry
Freeman JV, Varosy P, Price MJ, Slotwiner D, Kusumoto FM, Rammohan C, Kavinsky CJ, Turi ZG, Akar J, Koutras C, Curtis JP, Masoudi FA. The NCDR Left Atrial Appendage Occlusion Registry. Journal Of The American College Of Cardiology 2020, 75: 1503-1518. PMID: 32238316, PMCID: PMC7205034, DOI: 10.1016/j.jacc.2019.12.040.Peer-Reviewed Original ResearchConceptsHospital adverse event ratesAdverse event ratesEvent ratesMean HAS-BLED scoreHAS-BLED scoreHospital adverse eventsMean patient ageAtrial appendage occlusionMedian annual numberMajor bleedingMean CHAMore comorbiditiesVASc scoreWATCHMAN procedureAdverse eventsCommon complicationPatient agePericardial effusionPivotal trialsAppendage occlusionRandomized trialsAtrial fibrillationPatient populationPresent patientPhysician characteristics