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 regression
2023
Initial 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
2021
Cannabis 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 dataCUDCannabisRelation 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 subgroupsPatterns 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 infarctionShared decision-making in atrial fibrillation: patient-reported involvement in treatment decisions
Ali-Ahmed F, Pieper K, North R, Allen LA, Chan PS, Ezekowitz MD, Fonarow GC, Freeman JV, Go AS, Gersh BJ, Kowey PR, Mahaffey KW, Naccarelli GV, Pokorney SD, Reiffel JA, Singer DE, Steinberg BA, Peterson ED, Piccini JP, O’Brien E. Shared decision-making in atrial fibrillation: patient-reported involvement in treatment decisions. European Heart Journal - Quality Of Care And Clinical Outcomes 2020, 6: 263-272. PMID: 32392287, PMCID: PMC7778449, DOI: 10.1093/ehjqcco/qcaa040.Peer-Reviewed Original ResearchConceptsAtrial fibrillationTreatment decisionsHealthcare providersNew-onset atrial fibrillationHalf of patientsAvailable therapeutic optionsBetter Informed TreatmentHCP recommendationOutcomes RegistryRhythm controlTherapeutic optionsPatient understandingHigher oddsPatientsInformed TreatmentUS sitesFibrillationFuture interventionsPotential targetHigher likelihoodSelf-reported understandingTreatmentSDMSubstudyOptionsEnhanced electrocardiographic monitoring of patients with Coronavirus Disease 2019
Jain S, Workman V, Ganeshan R, Obasare ER, Burr A, DeBiasi RM, Freeman JV, Akar J, Lampert R, Rosenfeld LE. Enhanced electrocardiographic monitoring of patients with Coronavirus Disease 2019. Heart Rhythm 2020, 17: 1417-1422. PMID: 32387247, PMCID: PMC7200355, DOI: 10.1016/j.hrthm.2020.04.047.Peer-Reviewed Original ResearchConceptsQT prolongationCoronavirus disease 2019Electrocardiographic monitoringDisease 2019Pandemic coronavirus disease 2019QT-prolonging medicationsModifiable risk factorsIntensive care unitQT-prolonging drugsOngoing pandemic coronavirus disease 2019Assessment-Recommendation (SBAR) toolCOVID-19Electrophysiology serviceElectrolyte abnormalitiesCare unitUnique patientsPrimary teamRisk factorsPatientsPatient safetyECG monitoringProlongationRelevant interventionsTorsadesPointesSwitching warfarin to direct oral anticoagulants in atrial fibrillation: Insights from the NCDR PINNACLE registry
Sciria CT, Maddox TM, Marzec L, Rodwin B, Virani SS, Annapureddy A, Freeman JV, O'Hare A, Liu Y, Song Y, Doros G, Zheng Y, Lee JJ, Daggubati R, Vadlamani L, Cannon C, Desai NR. Switching warfarin to direct oral anticoagulants in atrial fibrillation: Insights from the NCDR PINNACLE registry. Clinical Cardiology 2020, 43: 743-751. PMID: 32378265, PMCID: PMC7368350, DOI: 10.1002/clc.23376.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsAF patientsAtrial fibrillationOral anticoagulantsAvailability of DOACsChronic warfarin therapyMultivariable hierarchical regressionNCDR PINNACLE RegistryPattern of anticoagulationProspective cohort studyPractice-level factorsPractice-level variationPINNACLE RegistryPrescribed warfarinSwitched patientsClinical characteristicsCohort studyStroke riskWarfarin therapyCurrent guidelinesPatientsWarfarinAnticoagulationPrivate insuranceSignificant predictors
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 hospitalizationComparison of Long-Term Adverse Outcomes in Patients With Atrial Fibrillation Having Ablation Versus Antiarrhythmic Medications
Freeman JV, Tabada GH, Reynolds K, Sung SH, Singer DE, Wang PJ, Liu TI, Gupta N, Hlatky MA, Go AS. Comparison of Long-Term Adverse Outcomes in Patients With Atrial Fibrillation Having Ablation Versus Antiarrhythmic Medications. The American Journal Of Cardiology 2019, 125: 553-561. PMID: 31843233, PMCID: PMC6987016, DOI: 10.1016/j.amjcard.2019.11.004.Peer-Reviewed Original ResearchConceptsTransient ischemic attackChronic antiarrhythmic therapyHeart failure hospitalizationIschemic attackAntiarrhythmic therapyAF ablationIschemic strokeIntracranial hemorrhageAntiarrhythmic medicationsFailure hospitalizationCatheter ablationAdverse outcomesAdjusted ratesKaiser Permanente Northern CaliforniaLong-term adverse outcomesAtrial fibrillation catheter ablationAF catheter ablationHigh-dimensional propensity scoreHistory of diabetesHistory of hypertensionCoronary heart diseaseHealthcare delivery systemCause hospitalizationObservational cohortHeart failureTreatment 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
Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus
Hummel JP, Kadado AJ, Baker M, Gehi AK, Mounsey JP, Sadaf MI, Enriquez AD, Freeman JV, Akar JG. Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus. Circulation Arrhythmia And Electrophysiology 2018, 11: e006814. PMID: 30562101, DOI: 10.1161/circep.118.006814.Peer-Reviewed Original ResearchAssociation of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II.
Essien UR, Holmes DN, Jackson LR, Fonarow GC, Mahaffey KW, Reiffel JA, Steinberg BA, Allen LA, Chan PS, Freeman JV, Blanco RG, Pieper KS, Piccini JP, Peterson ED, Singer DE. Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II. JAMA Cardiology 2018, 3: 1174-1182. PMID: 30484833, PMCID: PMC6583087, DOI: 10.1001/jamacardio.2018.3945.Peer-Reviewed Original ResearchConceptsDirect-acting oral anticoagulantsAtrial Fibrillation IIOral anticoagulant useOral anticoagulantsBetter Informed TreatmentAtrial fibrillationAnticoagulant useRace/ethnicityWhite individualsOutcomes RegistryHispanic individualsBlack individualsInformed TreatmentOne-year persistenceOral anticoagulant discontinuationQuality of anticoagulationEthnic differencesSelf-reported race/ethnicitySocioeconomic factorsQuality of careHispanic groupsAnticoagulant discontinuationDOAC useInappropriate dosingCohort studyB-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 CHAStroke Risk and Treatment in Patients with Atrial Fibrillation and Low CHA2DS2‐VASc Scores: Findings From the ORBIT‐AF I and II Registries
Jackson L, Kim S, Fonarow GC, Freeman JV, Gersh BJ, Go AS, Hylek EM, Kowey PR, Mahaffey KW, Singer D, Thomas L, Blanco R, Peterson ED, Piccini J, Patients and Investigators T. Stroke Risk and Treatment in Patients with Atrial Fibrillation and Low CHA2DS2‐VASc Scores: Findings From the ORBIT‐AF I and II Registries. Journal Of The American Heart Association 2018, 7: e008764. PMID: 30369317, PMCID: PMC6201408, DOI: 10.1161/jaha.118.008764.Peer-Reviewed Original ResearchConceptsOral anticoagulationAtrial fibrillationTreatment strategiesCardiology/American Heart Association guidelinesStroke/transient ischemic attackLow CHA2DS2-VASc scoreAmerican Heart Association guidelinesCHA2DS2-VASc scoreThromboembolic event rateTransient ischemic attackHeart Association guidelinesCurrent American CollegePatterns of treatmentIschemic attackVASc scoreCause mortalityStroke riskTreatment patternsAbsolute riskAssociation guidelinesStroke rateVAScAmerican CollegeLower riskPatients