Contemporary procedural trends of Watchman percutaneous left atrial appendage occlusion in the United States
| العنوان: | Contemporary procedural trends of Watchman percutaneous left atrial appendage occlusion in the United States |
|---|---|
| المؤلفون: | Sudarshan Balla, Muhammad Bilal Munir, Douglas Darden, Ryan Reeves, Jonathan C. Hsu, Muhammad Zia Khan, Frederick T. Han, Deepak Kumar Pasupula |
| المصدر: | Journal of cardiovascular electrophysiology, vol 32, iss 1 J Cardiovasc Electrophysiol |
| بيانات النشر: | eScholarship, University of California, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Percutaneous, complications, medicine.medical_treatment, 030204 cardiovascular system & hematology, Cardiorespiratory Medicine and Haematology, Left atrial appendage occlusion, Article, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Coagulopathy, Humans, Atrial Appendage, 030212 general & internal medicine, Adverse effect, Watchman, Retrospective Studies, business.industry, Anticoagulants, Atrial fibrillation, Retrospective cohort study, Odds ratio, national trends, Hematology, medicine.disease, mortality, Confidence interval, United States, Brain Disorders, Stroke, Treatment Outcome, Good Health and Well Being, Cardiovascular System & Hematology, Cardiology and Cardiovascular Medicine, business |
| الوصف: | OBJECTIVE: To determine trends in real-world utilization and in-hospital adverse events from Watchman implantation since its approval by the Food and Drug Administration in 2015. BACKGROUND: The risk of embolic stroke caused by atrial fibrillation is reduced by oral anticoagulants, but not all patients can tolerate long-term anticoagulation. Left atrial appendage occlusion with the Watchman device has emerged as an alternative therapy. METHODS: This was a retrospective cohort study utilizing data from National In-patient Sample for calendar years 2015–2017. The outcomes assessed in this study were associated complications, in-hospital mortality, and resource utilization trends after Watchman implantation. Trends analysis were performed using analysis of variance. Multivariable adjusted logistic regression analysis was performed to determine predictors of mortality. RESULTS: A total of 17 700 patients underwent Watchman implantation during the study period. There was a significantly increased trend in the number of Watchman procedures performed over the study years (from 1195 in 2015 to 11 165 devices in 2017, p < .01). A significant decline in the rate of complications (from 26.4% in 2015% to 7.9% in 2017, p < .01) and inpatient mortality (from 1.3% in 2015% to 0.1% in 2017, p < .01) were noted. Predictors of in-hospital mortality included a higher CHA(2)DS(2)-VASc score (odds ratio [OR]: 2.61 per 1-point increase, 95% confidence interval [CI]: 1.91–3.57), chronic blood loss anemia (OR: 3.63, 95% CI: 1.37–9.61) and coagulopathy (OR: 4.90, 95% CI: 2.32–10.35). CONCLUSION: In contemporary United States clinical practice, Watchman utilization has increased significantly since approval in 2015, while complications and in-patient mortality have declined. |
| وصف الملف: | application/pdf |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d552e164d6e82d99dd224c9dedf21147Test https://escholarship.org/uc/item/7cn648f6Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d552e164d6e82d99dd224c9dedf21147 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |