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 age
2022
Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices
Price M, Friedman D, Du C, Wang Y, Lin Z, Curtis J, Freeman J. Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices. JACC Cardiovascular Interventions 2022, 15: 2115-2123. PMID: 36357014, DOI: 10.1016/j.jcin.2022.09.002.Peer-Reviewed Original ResearchConceptsHospital major adverse eventsMajor adverse eventsWatchman FLXMajor vascular complicationsMajor bleedingPericardial effusionCardiac arrestDevice embolizationVascular complicationsMyocardial infarctionLower ratesSystemic arterial embolismComposite of deathTransient ischemic attackAtrial appendage occlusionSignificant lower rateBalance of risksHospital mortalityIschemic attackArterial embolismHospital outcomesPrimary endpointStroke preventionAdverse eventsProcedural complicationsDevelopment and validation of an automated algorithm for end point adjudication for a large U.S. national registry
Friedman DJ, Pierre D, Wang Y, Gambone L, Koutras C, Segawa C, Farb A, Vemulapalli S, Varosy PD, Masoudi FA, Lansky A, Curtis JP, Freeman JV. Development and validation of an automated algorithm for end point adjudication for a large U.S. national registry. American Heart Journal 2022, 254: 102-111. PMID: 36007567, DOI: 10.1016/j.ahj.2022.08.006.Peer-Reviewed Original ResearchConceptsEnd point adjudicationCEC adjudicationEnd pointLarge registriesClinical trialsNational Cardiovascular Data RegistryMajor vascular complicationsU.S. National RegistryPost-discharge eventsAgreement rateMajor bleedingNeurologic eventsVascular complicationsNational registryEvent adjudicationData registryRegistryCommittee's evaluationsPercent agreementGold standardAgreement thresholdHospitalTrialsFurther confirmationBleedingClinical 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 proportionDaysAnticoagulationClinical 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-Meier
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 disease
2020
Effect 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 criteriaOutcomes of Cardiac Catheterization in Patients With Atrial Fibrillation on Anticoagulation in Contemporary in Practice
Sherwood MW, Piccini JP, Holmes DN, Pieper KS, Steinberg BA, Fonarow GC, Allen LA, Naccarelli GV, Kowey PR, Gersh BJ, Mahaffey KW, Singer DE, Ansell JE, Freeman JV, Chan PS, Reiffel JA, Blanco R, Peterson ED, Rao SV. Outcomes of Cardiac Catheterization in Patients With Atrial Fibrillation on Anticoagulation in Contemporary in Practice. Circulation Cardiovascular Interventions 2020, 13: e008274. PMID: 32408815, DOI: 10.1161/circinterventions.119.008274.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAnticoagulantsAtrial FibrillationCardiac CatheterizationDrug Administration ScheduleFactor Xa InhibitorsFemaleHemorrhageHumansMaleMiddle AgedPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsRegistriesRisk AssessmentRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesWarfarinConceptsDirect-Acting Oral AnticoagulantsActing Oral AnticoagulantsOral anticoagulationCardiac catheterizationRadial artery accessAtrial fibrillationMajor bleedingOral anticoagulantsMedian ageArtery accessAtrial Fibrillation II registryPatients' median ageReal-world registryChronic kidney diseaseThird of patientsBetter Informed TreatmentManagement of patientsOAC typeAntiplatelet therapyDiabetes mellitusFemoral accessContemporary cohortOutcomes RegistryKidney diseaseMyocardial infarctionThe 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
2019
Outcomes and Anticoagulation Use After Catheter Ablation for Atrial Fibrillation
Freeman JV, Shrader P, Pieper KS, Allen LA, Chan PS, Fonarow GC, Gersh BJ, Kowey PR, Mahaffey KW, Naccarelli G, Reiffel JA, Singer DE, Go AS, Hylek EM, Steinberg BA, Peterson ED, Piccini JP. Outcomes and Anticoagulation Use After Catheter Ablation for Atrial Fibrillation. Circulation Arrhythmia And Electrophysiology 2019, 12: e007612. PMID: 31830822, DOI: 10.1161/circep.119.007612.Peer-Reviewed Original ResearchConceptsAF catheter ablationOral anticoagulationRisk of strokeAF ablationCatheter ablationAntiarrhythmic medicationsDe novo AF ablationDiscontinuation of OACPropensity score-matched cohortAtrial fibrillation catheter ablationAF ablation patientsAnti-arrhythmic medicationsAtrial Fibrillation RegistryStroke prevention therapyBetter Informed TreatmentCohort of patientsPatterns of treatmentProportional hazards regressionUS national registryAnticoagulation useCause deathMajor bleedingSystemic embolismCardiovascular deathCause hospitalizationTreatment of atrial fibrillation with concomitant coronary or peripheral artery disease: Results from the outcomes registry for better informed treatment of atrial fibrillation II
Inohara T, Shrader P, Pieper K, Blanco RG, Allen LA, Fonarow GC, Gersh BJ, Go AS, Ezekowitz MD, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Mahaffey KW, Singer DE, Freeman JV, Steinberg BA, Peterson ED, Piccini JP, Patients and Investigators O. Treatment of atrial fibrillation with concomitant coronary or peripheral artery disease: Results from the outcomes registry for better informed treatment of atrial fibrillation II. American Heart Journal 2019, 213: 81-90. PMID: 31129441, DOI: 10.1016/j.ahj.2019.04.007.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticoagulantsAtrial FibrillationCardiovascular DiseasesCoronary Artery DiseaseDrug Therapy, CombinationFactor Xa InhibitorsFemaleHemorrhageHumansMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationPeripheral Arterial DiseasePlatelet Aggregation InhibitorsProportional Hazards ModelsProspective StudiesRegistriesStrokeTreatment OutcomeWarfarinConceptsNew-onset atrial fibrillationDirect oral anticoagulantsConcomitant antiplatelet therapyPeripheral artery diseaseAtrial fibrillationVascular diseaseAntiplatelet therapyMajor bleedingArtery diseaseMyocardial infarctionORBIT-AF II registryAtrial Fibrillation IIImproved cardiovascular outcomesVascular disease patientsProportional hazards modelOutcomes of individualsOral anticoagulationCardiovascular outcomesOral anticoagulantsTriple therapyMost patientsPatient characteristicsCoronary diseaseDual therapyNeurological events
2018
B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation
Inohara T, Kim S, Pieper K, Blanco RG, Allen LA, Fonarow GC, Gersh BJ, Ezekowitz MD, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Mahaffey KW, Singer DE, Freeman JV, Steinberg BA, Peterson ED, Piccini JP. B-type natriuretic peptide, disease progression and clinical outcomes in atrial fibrillation. Heart 2018, 105: 370. PMID: 30228248, DOI: 10.1136/heartjnl-2018-313642.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAtrial fibrillationAF progressionBNP levelsMajor bleedingBNP valuesNatriuretic peptideDisease progressionAtrial Fibrillation II registryBiomarker-based risk stratificationElevated BNP valuesBetter Informed TreatmentPersistent atrial fibrillationCox frailty modelCardiovascular outcomesComposite outcomeBNP concentrationsNeurological eventsClinical outcomesOutcomes RegistryRisk stratificationPatient outcomesInformed TreatmentPatientsBleedingPharmacotherapy for Atrial Fibrillation in Patients With Chronic Kidney Disease: Insights From ORBIT‐AF
Washam JB, Holmes DN, Thomas LE, Pokorney SD, Hylek EM, Fonarow GC, Mahaffey KW, Gersh BJ, Kowey PR, Ansell JE, Go AS, Reiffel JA, Freeman JV, Singer DE, Naccarelli G, Blanco R, Peterson ED, Piccini JP. Pharmacotherapy for Atrial Fibrillation in Patients With Chronic Kidney Disease: Insights From ORBIT‐AF. Journal Of The American Heart Association 2018, 7: e008928. PMID: 30371218, PMCID: PMC6222961, DOI: 10.1161/jaha.118.008928.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAged, 80 and overAnti-Arrhythmia AgentsAnticoagulantsAtrial FibrillationDabigatranDrug Therapy, CombinationFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRegistriesRenal Insufficiency, ChronicRisk FactorsStrokeTime FactorsTreatment OutcomeWarfarinConceptsBackground Chronic kidney diseaseAntiarrhythmic drug useTransient ischemic attackChronic kidney diseaseAtrial fibrillationAdvanced CKDCKD statusIschemic attackSystemic embolismCause mortalityCreatinine clearanceRhythm controlKidney diseaseDrug useAtrial fibrillation scoreBaseline renal functionOral anticoagulant useRhythm control strategyCox proportional hazardsCKD patientsMajor bleedingOAC useCardiovascular deathCKD stageHigher CHAPrognostic Significance of Nuisance Bleeding in Anticoagulated Patients With Atrial Fibrillation
O'Brien EC, Holmes DN, Thomas LE, Fonarow GC, Allen LA, Gersh BJ, Kowey PR, Singer DE, Ezekowitz MD, Naccarelli GV, Ansell JE, Chan PS, Mahaffey KW, Go AS, Freeman JV, Reiffel JA, Peterson ED, Piccini JP, Hylek EM. Prognostic Significance of Nuisance Bleeding in Anticoagulated Patients With Atrial Fibrillation. Circulation 2018, 138: 889-897. PMID: 29678813, DOI: 10.1161/circulationaha.117.031354.Peer-Reviewed Original ResearchConceptsStroke/systemic embolismMajor bleedingOral anticoagulantsAtrial fibrillationMinor bleeding eventsSubset of patientsVASc risk scorePooled logistic regressionYears of ageBleeding eventsEligible followOAC discontinuationOAC therapyOutpatient registrySystemic embolismAnticoagulated patientsMinor bleedingMedian ageTreatment satisfactionPrognostic significanceNuisance bleedingMedical recordsORBIT-AFIncidence ratePatient visitsAssociation of Atrial Fibrillation Clinical Phenotypes with Treatment Patterns and Outcomes: A Multicenter Registry Study
Inohara T, Shrader P, Pieper K, Blanco RG, Thomas L, Singer DE, Freeman JV, Allen LA, Fonarow GC, Gersh B, Ezekowitz MD, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Steinberg BA, Peterson ED, Piccini JP. Association of Atrial Fibrillation Clinical Phenotypes with Treatment Patterns and Outcomes: A Multicenter Registry Study. JAMA Cardiology 2018, 3: 54-63. PMID: 29128866, PMCID: PMC5833527, DOI: 10.1001/jamacardio.2017.4665.Peer-Reviewed Original ResearchConceptsAtrial fibrillationAtherosclerotic comorbiditiesMajor bleedingComorbidity clustersNeurological eventsClinical outcomesDevice implantationORBIT-AF II registryPrior coronary artery diseaseAtrial Fibrillation RegistryComorbid behavioral disordersMulticenter registry studyBaseline clinical characteristicsImportance of comorbiditiesBetter Informed TreatmentSinus node dysfunctionCoronary artery diseaseData-driven cluster analysisHemostasis criteriaClinical characteristicsObservational cohortRegistry studyTotal patientsArtery diseaseAtrial size
2017
Treatment of Atrial Fibrillation and Concordance With the American Heart Association/American College of Cardiology/Heart Rhythm Society Guidelines
Barnett AS, Kim S, Fonarow GC, Thomas LE, Reiffel JA, Allen LA, Freeman JV, Naccarelli G, Mahaffey KW, Go AS, Kowey PR, Ansell JE, Gersh BJ, Hylek EM, Peterson ED, Piccini JP. Treatment of Atrial Fibrillation and Concordance With the American Heart Association/American College of Cardiology/Heart Rhythm Society Guidelines. Circulation Arrhythmia And Electrophysiology 2017, 10: e005051. PMID: 29141842, DOI: 10.1161/circep.117.005051.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAmerican Heart AssociationAtrial FibrillationCardiologistsFemaleGuideline AdherenceHealthcare DisparitiesHumansMaleMiddle AgedPractice Guidelines as TopicPractice Patterns, Physicians'Process Assessment, Health CareQuality Indicators, Health CareRegistriesRetrospective StudiesTime FactorsTreatment OutcomeUnited StatesConceptsAmerican Heart Association/American CollegeAtrial fibrillationGuideline recommendationsAmerican CollegeCardiology/Heart Rhythm Society GuidelinesHeart Rhythm Society guidelinesAtrial fibrillation guidelinesGuideline-concordant careThird of patientsRisk-adjusted outcomesAntiarrhythmic medicationsGuideline concordanceMajor bleedingMedian CHAOutpatient registryVASc scoreAntithrombotic therapyCause hospitalizationMedian ageClinical outcomesSociety guidelinesORBIT-AFImproved outcomesPatient levelSimilar risk
2015
Association Between Atrial Fibrillation Symptoms, Quality of Life, and Patient Outcomes
Freeman JV, Simon DN, Go AS, Spertus J, Fonarow GC, Gersh BJ, Hylek EM, Kowey PR, Mahaffey KW, Thomas LE, Chang P, Peterson ED, Piccini JP. Association Between Atrial Fibrillation Symptoms, Quality of Life, and Patient Outcomes. Circulation Cardiovascular Quality And Outcomes 2015, 8: 393-402. PMID: 26058720, DOI: 10.1161/circoutcomes.114.001303.Peer-Reviewed Original ResearchConceptsQuality of lifeAtrial fibrillationHigh riskAF patientsAF symptomsPatient outcomesSymptom severityAtrial Fibrillation EffectBorderline higher riskMajor adverse eventsBetter Informed TreatmentAtrial fibrillation symptomsCommunity-based studyAFEQT scoreEHRA classMajor bleedingMost patientsSymptom burdenAdverse eventsOutcomes RegistryCox regressionLife QuestionnaireFibrillation EffectInformed TreatmentPatients