Outcomes and predictors of readmission after implantation of a percutaneous left atrial appendage occlusion device in the United States: A propensity score‐matched analysis from The National Readmission Database

Pasupula, Deepak Kumar; Munir, Muhammad Bilal; Bhat, Anusha Ganapati; Malleshappa, Sudeep K Siddappa; Meera, Srinidhi J.; Spooner, Michael; Koranne, Ketan; Olshansky, Brian; Hirji, Sameer; Hsu, Jonathan C.

doi:10.1111/jce.15247

Cited by 5 publications

(4 citation statements)

References 20 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The observed 8.2% readmission rate at 30 days is slightly lower than that reported in previous studies, in which the overall 30-day readmission rate was 9.4%. 16 , 17 Moreover, the rates were lower than those reported for other catheter-based cardiac procedures, including catheter ablation for atrial fibrillation (11%), 18 , 19 transcatheter aortic valve implantation (11%), 20 and transcatheter edge-to-edge mitral valve repair (14%-16%). 21 , 22 …”

Section: Discussionmentioning

confidence: 81%

Readmissions After Left Atrial Appendage Closure in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

Sparrow,

Sposato,

Alkhouli

et al. 2023

CJC Open

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 81%

Readmissions After Left Atrial Appendage Closure in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

Sparrow,

Sposato,

Alkhouli

et al. 2023

CJC Open

View full text Add to dashboard Cite

“…An amount of 125 patients (15.5%) died within the first year of LAAC in the study of Mesnier et al In the multivariable analysis, a factor associated with early death after LAAC was older age (HR: 1.03; 95% CI: 1.01–1.06 per year; p = 0.01) [ 30 ]. In addition, one study concluded that advanced age is associated with readmission after LAAC [ 31 ]. We also calculated the prevalence of comorbid conditions, such as coronary artery disease, congestive cardiac failure, and diabetes mellitus, between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Appendage Closure for Atrial Fibrillation in the Elderly >75 Years Old: A Meta-Analysis of Observational Studies

et al. 2022

View full text Add to dashboard Cite

Background: Left atrial appendage closure (LAAC) is an established therapy for patients with atrial fibrillation (AF); however, there is a limited understanding of LAAC in elderly patients (≥75 years old). We conducted a meta-analysis to investigate the procedural complications and long-term outcomes after LAAC in the elderly versus the non-elderly. Methods: We screened PubMed, EMBASE, Cochrane Library, and Web of Science. Procedural endpoints of interest included successful implantation LAAC rates, in-hospital mortality, major bleeding events, pericardial effusion/tamponade, stroke, and vascular access complications related to LAAC. Long-term outcomes included all-cause mortality, major bleeding events, and stroke/transient ischemic attack (TIA) during follow-up. Results: Finally, 12 studies were included in the analysis; these included a total of 25,094 people in the elderly group and 36,035 people in the non-elderly group. The successful implantation LAAC rates did not differ between the groups, while the elderly patients experienced more periprocedural mortality (OR 2.62; 95% CI 1.79–3.83, p < 0.01; I2 = 0%), pericardial effusion/tamponade (OR 1.39; 95% CI: 1.06–1.82, p < 0.01; I2 = 0%), major bleeding events (OR 1.32; 95% CI 1.17–1.48, p < 0.01; I2 = 0%), and vascular access complications (OR 1.34; 95% CI 1.16–1.55, p < 0.01; I2 = 0%) than the non-elderly patients. The long-term stroke/TIA rates did not differ between the elderly and the non-elderly at least one year after follow-up. Conclusions: Even though successful implantation LAAC rates are similar, elderly patients have a significantly higher incidence of periprocedural mortality, major bleeding events, vascular access complications, and pericardial effusion/tamponade after LAAC than non-elderly patients. The stroke/TIA rates did not differ between both groups after at least one-year follow-up.

show abstract

“…This methodology of identifying patients undergoing LAAO implantation and catheter-directed AF ablation from administrative databases has been adopted and validated in previous studies. 5 , 6 Our population of interest were patients undergoing LAAO + CA on the same day: therefore, patients undergoing LAAO or CA on different days during the same hospitalization were excluded (unweighted n = 23). Additionally, patients hospitalized in December were excluded (unweighted n = 78).…”

Section: Methodsmentioning

confidence: 99%

“…Similarly, the use of left atrial appendage occlusion (LAAO) devices, such as the Watchman® device (Boston Scientific) and the Amulet® device (Abbott), has increased significantly in the USA 5 with lower in-hospital mortality and rehospitalization rates compared with matched AF cohorts. 6–8 LAAO is proven to reduce haemorrhagic stroke risk when compared with warfarin among non-valvular AF patients. 9–12 Combining AF ablation and implantation of LAAO device is expected to provide additive benefits in non-pharmacologic AF management.…”

Section: Introductionmentioning

confidence: 99%

Combined atrial fibrillation ablation and left atrial appendage occlusion procedure in the United States: a propensity score matched analysis from 2016–2019 national readmission database

et al. 2022

Self Cite

View full text Add to dashboard Cite

Aims The safety and feasibility of combining percutaneous catheter ablation (CA) for atrial fibrillation with left atrial appendage occlusion (LAAO) as a single procedure in the USA have not been investigated. We analyzed the US National Readmission Database (NRD) to investigate the incidence of combined LAAO + CA and compare major adverse cardiovascular events (MACEs) with matched LAAO-only and CA-only patients. Methods and results In this retrospective study from NRD data, we identified patients undergoing combined LAAO and CA procedures on the same day in the USA from 2016 to 2019. A 1:1 propensity score match was performed to identify patients undergoing LAAO-only and CA-only procedures. The number of LAAO + CA procedures increased from 28 (2016) to 119 (2019). LAAO + CA patients (n = 375, mean age 74 ± 9.2 years, 53.4% were males) had non-significant higher MACE (8.1%) when compared with LAAO-only (n = 407, 5.3%) or CA-only patients (n = 406, 7.4%), which was primarily driven by higher rate of pericardial effusion (4.3%). All-cause 30-day readmission rates among LAAO + CA patients (10.7%) were similar when compared with LAAO-only (12.7%) or CA-only (17.5%) patients. The most frequent primary reason for readmissions among LAAO + CA and LAAO-only cohorts was heart failure (24.6 and 31.5%, respectively), while among the CA-only cohort, it was paroxysmal atrial fibrillation (25.7%). Conclusion We report an 63% annual growth (from 28 procedures) in combined LAAO and CA procedures in the USA. There were no significant difference in MACE and all-cause 30-day readmission rates among LAAO + CA patients compared with matched LAAO-only or CA-only patients.

show abstract

Outcomes and predictors of readmission after implantation of a percutaneous left atrial appendage occlusion device in the United States: A propensity score‐matched analysis from The National Readmission Database

Cited by 5 publications

References 20 publications

Readmissions After Left Atrial Appendage Closure in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

Readmissions After Left Atrial Appendage Closure in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

Left Atrial Appendage Closure for Atrial Fibrillation in the Elderly >75 Years Old: A Meta-Analysis of Observational Studies

Combined atrial fibrillation ablation and left atrial appendage occlusion procedure in the United States: a propensity score matched analysis from 2016–2019 national readmission database

Contact Info

Product

Resources

About